Movahedi Tendon Transfer in Common Peroneal Nerve Palsy

The article's abstract is not available.

FOOT DROP FOLLOWING COVID-19 INFECTION. A CASE REPORT AND ITS OUTCOME

INTRODUCTION: Corona virus disease-19 (COVID-19) is one among the worst pandemics faced by mankind and there are various neurological manifestations either direct or indirect effect of Corona virus. Here we report a case of foot drop secondary to entrapment peroneal injury in COVID-19 patient as a sequelae of prone positioning. CASE REPORT: A 55-year-old gentleman was diagnosed with RT PCR positive COVID19 and was hospitalized for severe respiratory syndrome. HRCT thorax done showed CORADS score of 6 with severity index of 14/25. During this period, patient was on treatment according to ICMR guidelines and prone position for about 20 hours/day for 20 days for severe pneumonia. During follow up after 15 days of discharge, he had developed features of foot drop secondary to common peroneal nerve palsy which was later conrmed by electro diagnostic studies and nerve ultrasound. Patient was started on oral steroids and along with supportive measures. He is followed up for a period of 3 months and has noted 50% improvement in his symptoms. CONCLUSION: While prone positioning should continue to be utilized in COVID-19 pneumonia as dictated by the current literature, precaution has to be taken with it. Changing patient positioning at shorter intervals and timely mobilization are necessary.

Current Concepts Review: Common Peroneal Nerve Palsy After Knee Dislocations

Dislocation of the native knee represents a challenging injury, further complicated by the high rate of concurrent injury to the common peroneal nerve (CPN). Initial management of this injury requires a thorough neurovascular examination, given the prevalence of popliteal artery injury and limb-threatening ischemia. Further management of a knee dislocation with associated CPN palsy requires coordinated care involving the sports surgeon for ligamentous knee reconstruction and the peripheral nerve surgeon for staged or concurrent peroneal nerve decompression and/or reconstruction. Finally, the foot and ankle surgeon is often required to manage a foot drop with a distal tendon transfer to restore foot dorsiflexion. For instance, the Bridle Procedure—a modification of the anterior transfer of the posterior tibialis muscle, under the extensor retinaculum, with tri-tendon anastomosis to the anterior tibial and peroneus longus tendons at the anterior ankle—can successfully return patients to brace-free ambulation and athletic function following CPN palsy. Cross-discipline coordination and collaboration is essential to ensure appropriate timing of operative interventions and ensure maintenance of passive dorsiflexion prior to tendon transfer.

Common Peroneal Nerve Palsy Associated With Intraoperative Hypotension Following Total Thyroidectomy

Perioperative peroneal neuropathy is an uncommon complication following surgeries performed with patients positioned supine. It may be caused by various factors aside from intraoperative compression. The authors report a case of common peroneal nerve palsy in a patient who underwent total thyroidectomy with central and bilateral selective neck dissection. The patient’s body mass index was 31.3 kg/m2. She was positioned supine and the operative time was 7-h. During surgery, her mean arterial pressure intermittently dropped to 50-60 mmHg for 55 min and 61-70 mmHg for 195 min. She developed common peroneal nerve palsy on postoperative day 1. Nevertheless, the patient fully recovered without any complications within 3 weeks.