scholarly journals Entrapment of Common Peroneal Nerve by Surgical Suture following Distal Biceps Femoris Tendon Repair

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Aki Fukuda ◽  
Akinobu Nishimura ◽  
Shigeto Nakazora ◽  
Ko Kato ◽  
Akihiro Sudo
Keyword(s):  
Peroneal Nerve ◽  
Surgical Repair ◽  
Tendon Repair ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Complete Removal ◽  
Distal Biceps ◽  
Surgical Suture ◽  
The Common ◽  
Biceps Femoris Tendon

We describe entrapment of the common peroneal nerve by a suture after surgical repair of the distal biceps femoris tendon. Complete rupture of the distal biceps femoris tendon of a 16-year-old male athlete was surgically repaired. Postoperative common peroneal nerve palsy was evident, but conservative treatment did not cause any neurological improvement. Reexploration revealed that the common peroneal nerve was entrapped by the surgical suture. Complete removal of the suture and external neurolysis significantly improved the palsy. The common peroneal nerve is prone to damage as a result of its close proximity to the biceps femoris tendon and it should be identified during surgical repair of a ruptured distal biceps femoris tendon.

scholarly journals A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jeong-Hyun Park ◽  
Jinseo Yang ◽  
Kwang-Rak Park ◽  
Tae Woo Kim ◽  
Taeyeong Kim ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Gastrocnemius Muscle ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Biceps Femoris Muscle ◽  
Distal Biceps ◽  
The Common ◽  
The Relationship ◽  
Femoris Muscle ◽  
Lateral Head

The most frequent mononeuropathy in the lower extremity has been reported as the common peroneal nerve entrapment neuropathy (CPNe) around the head and neck of the fibula, although the mechanism of the neuropathy in this area cannot be fully explained. Therefore, the aim of this cadaveric study was to evaluate the relationship between morphologic variations of the distal biceps femoris muscle (BFM) and the course of the common peroneal nerve (CPN) and to investigate the incidence and morphological characteristics of anatomical variations in the BFM associated with CPNe. The popliteal region and the thigh were dissected in 115 formalin-fixed lower limbs. We evaluated consensus for (1) normal anatomy of the distal BFM, (2) anatomic variations of this muscle, and (3) the relationship of the muscle to the CPN. Measurements of the distal extents of the short and long heads of the BFM from insertion (fibular head) were performed. Two anatomic patterns were seen. First, in 93 knees (80.8%), the CPN ran obliquely along the lateral side of the BFM and then superficial to the lateral head of the gastrocnemius muscle. Second, in 22 cases (19.2%), the CPN coursed within a tunnel between the biceps femoris and lateral head of the gastrocnemius muscle (LGCM). There was a positive correlation between the distal extents of the short heads of the biceps femoris muscle (SHBFM) and the presence of the tunnel. The “popliteal intermuscular tunnel” in which the CPN travels can be produced between the more distal extension variant of the SHBFM and the LGCM. This anatomical variation of BFM may have a clinical significance as an entrapment area of the CPN in the patients in which the mechanism of CPNe around the fibula head and neck is not understood.

scholarly journals Diagnóstico y tratamiento de la entesopatía distal del bíceps crural en un corredor profesional (Diagnosis and treatment of distal biceps femoris tendon enthesopathy in a professional runner)

2019 ◽  
Vol 0 (Avance Online) ◽  
Author(s):  
Antonio León Garrigosa
Keyword(s):  
Peroneal Nerve ◽  
Histological Study ◽  
Treatment Strategies ◽  
Biceps Femoris ◽  
Complete Recovery ◽  
Postoperative Management ◽  
Distal Biceps ◽  
Temporary Relief ◽  
El Sistema ◽  
Biceps Femoris Tendon

RESUMEN Objetivo: describir el diagnóstico y tratamiento de la entesopatía del tendón distal del bíceps crural en un corredor profesional. Método: el diagnóstico se obtuvo mediante datos clínicos y exploraciones complementarias. Describimos la técnica quirúrgica, el manejo post-operatorio y el sistema de valoración empleado en el seguimiento. Resultados: el diagnóstico se confirmó histológicamente. La recuperación funcional fue completa. Conclusión: solo hemos encontrado otro caso publicado de entesopatía del tendón distal del bíceps crural, sin referencia a afectación del nervio ciático poplíteo externo. Si el tratamiento conservador no resuelve la sintomatología, puede estar indicada la cirugía. ABSTRACT Objective: to describe the diagnostic and treatment strategies for distal biceps femoris tendon enthesopathy, in a professional runner. Method: The diagnosis was based on clinical and complementary studies. The surgical technique, postoperative management and assessment, are described. Results: Histological study confirmed the diagnosis and the clinical outcome was satisfactory, with complete recovery after surgical management. Conclusion: there is only one published study assessing distal biceps femoris tendon enthesopathy. The possible involvement of the peroneal nerve has not been previously considered. If conservative treatment only provides temporary relief of symptoms, then surgery can be indicated. RESUMO Objetivo: descrever o diagnóstico e tratamento da entesopatia do tendão crural do bíceps distal em um corredor profissional. Método: o diagnóstico foi obtido por meio de dados clínicos e explorações complementares. Descrevemos a técnica cirúrgica, o manejo pós-operatório e o sistema de avaliação utilizado no acompanhamento. Resultados: o diagnóstico foi confirmado histologicamente. A recuperação funcional foi completa. Conclusão: encontramos apenas outro caso publicado de entesopatia do tendão distal do bíceps crural, sem referência ao envolvimento do nervo ciático poplíteo externo. Se o tratamento conservador não resolver os sintomas, a cirurgia pode ser indicada.

scholarly journals Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Takeshi Oshima ◽  
Junsuke Nakase ◽  
Hitoaki Numata ◽  
Yasushi Takata ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Case Report ◽  
Peroneal Nerve ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Postoperative Management ◽  
Return To Sports ◽  
First Case ◽  
Biceps Femoris Tendon

A multiple-ligament knee injury that includes posterolateral corner (PLC) disruption often causes palsy of the common peroneal nerve (CPN), which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

scholarly journals Congenital Entrapment of the Lateral Cutaneous Nerve of the Calf Presenting as a Peroneal Sensory Neuropathy

1998 ◽  
Vol 25 (2) ◽  
pp. 168-170 ◽  
Author(s):  
Daniel G. Hackam ◽  
Thomas J. Zwimpfer
Keyword(s):  
Peroneal Nerve ◽  
Sensory Neuropathy ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Popliteal Fossa ◽  
Cutaneous Nerve ◽  
Biceps Femoris Muscle ◽  
Normal Tendon ◽  
The Common ◽  
Lateral Cutaneous Nerve

ABSTRACT:Objective:Presentation of an unusual case of congenital entrapment of the lateral cutaneous nerve of the calf (LCNC) mimicking a peroneal sensory neuropathy.Methods:We report the case of a 16-year-old girl with a 3 year history of progressive tingling, numbness and pain in her right calf precipitated by athletic activities involving repeated flexion and extension of the knee. A Tinel's sign was present over the common peroneal nerve in the distal popliteal fossa but absent at the fibular neck. Motor and sensory examination of the common peroneal nerve was normal as were electrophysiological studies and MRI.Results:At surgery, the LCNC, a sensory branch of the common peroneal nerve, was entrapped at a point where it pierced the tendon of the biceps femoris muscle. Transection of the part of the tendon overlying the LCNC resulted in complete and permanent relief of symptoms.Significance and Conclusion:The proximal location of the Tinel's sign, absence of motor or sensory deficits and normal electrophysiology suggested, preoperatively, that this was not an entrapment of the common peroneal nerve at the fibular neck but rather a more proximal abnormality likely involving only a part of the peroneal nerve or one of its sensory branches. As a result, more proximal exposure of the peroneal nerve within the popliteal fossa revealed entrapment of the LCNC due to its anomalous course through the biceps femoris tendon. This case has two noteworthy features. It is a unique example of an entrapment neuropathy of the common peroneal nerve or one of its branches, due to a normal nerve piercing an otherwise normal tendon. Secondly, there are no previously reported cases of surgically documented compression of the LCNC in an otherwise normal patient (i.e., non-diabetic).

scholarly journals Osteoid Osteoma of the Proximal Fibula: An Uncommon Location with the Indication for Open Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Bastian Marquass ◽  
Pierre Hepp ◽  
Jan Dirk Theopold ◽  
Nikolaus von Dercks ◽  
Thomas R. Blattert ◽  
...  
Keyword(s):  
Osteoid Osteoma ◽  
Open Surgery ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Complete Removal ◽  
Tumor Location ◽  
Mri Scan ◽  
Proximal Fibula ◽  
Iatrogenic Damage ◽  
The Common

Purpose. This is a case report of a patient with an osteoid osteoma of the proximal fibula. The objective is to illustrate a rare tumor location that requires open surgery due to closeness of neurological structures.Methods. Clinical and roentgenographic findings, treatment, and histological appearance are presented.Results. Local pain and swelling of the proximal fibula with improvement under salicylates led to the diagnosis of an osteoid osteoma, what was confirmed with an MRI scan. Due to proximity to the common peroneal nerve, we decided for open surgery. During the operation, the nerve was seen to cross the tumor site making it necessary to retract it to expose the entire tumor. Histologically, typical features of osteoid osteoma with a rather well-defined nidus surrounded by sclerotic bone were seen. A complete removal was performed.Conclusion. Osteoid osteomas of the proximal fibula are rare. When planning surgery, the common peroneal nerve must be identified, and its further distal course should be taken into account to avoid iatrogenic damage to the nerve.

scholarly journals Establishment of a Sheep Model for Hind Limb Peripheral Nerve Injury: Common Peroneal Nerve

2021 ◽  
Vol 22 (3) ◽  
pp. 1401
Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana C. Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Small Sample ◽  
Therapeutic Options ◽  
Nerve Injuries ◽  
Sheep Model ◽  
The Common

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.

Displacement of the common peroneal nerve in posterolateral corner injuries of the knee

2005 ◽  
Vol 87-B (9) ◽  
pp. 1225-1226 ◽  
Author(s):  
N. Bottomley ◽  
A. Williams ◽  
R. Birch ◽  
A. Noorani ◽  
A. Lewis ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Posterolateral Corner ◽  
The Common

scholarly journals Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev
Keyword(s):  
Ankle Joint ◽  
Peroneal Nerve ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Common Peroneal Nerve ◽  
Diagnostic Methods ◽  
Fibular Head ◽  
Study Objective ◽  
The Common ◽  
The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

scholarly journals Establishment of a Sheep Model for Hind limb Peripheral Nerve Injury: Common Peroneal Nerve

2020 ◽  
Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana Catarina Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Peroneal Nerve ◽  
Hind Limb ◽  
Common Peroneal Nerve ◽  
Therapeutic Options ◽  
Large Animal ◽  
Sheep Model ◽  
The Common

Thousands of people worldwide suffer from injuries in the peripheral nerve and deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee effective outcomes, and the development of new and effective therapeutic options requires the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. In an integrative way, this article includes a detailed description of the anatomy and functionality of the peripheral nerves of sheep’s hind limb, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options. A neurological exam protocol directed to the common peroneal nerve was also established, allowing to identify the changes and deficits related with the nerve injury and to evaluate the functional progression over time. Finally, a preliminary stereological study was carried out to establish control values for the healthy peroneal common nerves of this model and to identify preliminary differences between therapeutic methods. The ultimate goal is to demonstrate that sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in human and veterinary patients.

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