Bilateral Common Peroneal Nerve Entrapment After Excessive Weight Loss: Case Report and Review of the Literature

Yushan

et al. 2021

Preprint

Background：Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients’ prognosis. Methods：This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results：The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR=3.35), occupation(“blue trouser” worker vs “white-trouser” worker, OR=4.39), diabetes (OR=11.68), cardiovascular disease (OR=51.35), knee joint dislocation (OR=14.91), proximal fibula fracture (OR=3.32), tibial plateau fracture (OR=9.21), vascular injury (OR=5.37) and hip arthroplasty (OR=75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR=0.18) and postoperative knee joint immobilization (OR=0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863-0.946.Conclusions：Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factor of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.

Section: Discussionmentioning

confidence: 65%

Prognostic factors in patients who underwent surgery for common peroneal nerve injury：a nest case-control study

Yushan

et al. 2021

Preprint

Section: Discussionmentioning

confidence: 65%

Prognostic factors in patients who underwent surgery for common peroneal nerve injury：a nest case-control study

Yushan

et al. 2020

Preprint

Background: Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients’ prognosis. Methods: This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results: The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR=3.35), occupation(“blue trouser” worker vs “white-trouser” worker, OR=4.39), diabetes (OR=11.68), cardiovascular disease (OR=51.35), knee joint dislocation (OR=14.91), proximal fibula fracture (OR=3.32), tibial plateau fracture (OR=9.21), vascular injury (OR=5.37) and hip arthroplasty (OR=75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR=0.18) and postoperative knee joint immobilization (OR=0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863-0.946. Conclusions: Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factor of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.

“…Bununla birlikte, proksimalde siyatik çentikte, distalde fibula boynunda fikse olması ve bacağın ön yüzüne doğru yönelirken yaptığı dik açılı dönüş, kompresyon nöropatisine duyarlı hale gelmesine neden olur (13) . Cerrahi (total diz artroplastisi, yüksek tibial osteotomi), travma (kontüzyon, gerilme ve ezilme yaralanmaları), diz bükme alışkanlığı, çömelme veya diz üstüne çökerek çalışma pozisyonu, yumuşak doku tümörleri, ganglion kistleri, kilo kaybı gibi birçok neden peroneal sinir nöropatisine neden olabilir (3)(4)(5)(6)(7)(8)(9)(10) .…”

Section: Discussionunclassified

“…Bu kaslar ayak bileğinin ve ayak baş parmağının dorsifleksiyonunu sağlar. PS travma, delici kesici alet yaralanması, ateşli silah yaralanması, dizin dislokasyonu, diz artroskopisi, yüksek tibial osteotomi prosedürü, nörojenik kist, intranöral gangliyon, hematom, ağır kaldırma, cerrahi işlem gibi nedenlerle hasara uğrayabilir (3)(4)(5)(6)(7)(8)(9)(10) .…”

Section: Introductionunclassified

Evaluation of Surgical Results of Peroneal Nerve Injury Due to Traumatic and Non-Traumatic Causes

Yüksel¹,

Çevik²

2020

İKSST

Peroneal sinir hasarı alt ekstremitenin sık görülen periferik sinir lezyonlarından biridir. Peroneal sinir travma, nörojenik kist, intranöral gangliyon, diz üzerine çökme, ağır kaldırma, cerrahi işlem gibi nedenlerle hasara uğrayabilir. Yaptığımız bu çalışmada, travmatik ve non-travmatik nedenlerle oluşan peroneal sinir hasarının cerrahi sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Diz seviyesinde peroneal sinir hasarı nedeniyle 2014-2018 yılları arasında kliniğimize başvuran ardışık 23 hasta retrosepektif olarak değerlendirildi. Hastaların ameliyat öncesi ve ameliyat sonrası 6. ay kontrol takiplerindeki ayak bileği dorsifleksyon kas gücü dereceleri değerlendirildi. Bulgular: Peroneal sinir hasarlı 23 [6 (%23) kadın, 17 (%77) erkek) hastanın 10'unu travmatik hasta grubuna ve 13 tanesi non travmatik hasta grubunda değerlendirildi. Her iki hasta grubunda da ameliyat öncesi ve ameliyat sonrası ABDF kas gücü iyileşmesi açısından istatiksel olarak cerrahinin etkinliği görülmüştür. Travmatik hasta grubunda ameliyat öncesi ABDF median kas gücü 0/5 (min.0/5-max.3/5) iken ameliyat sonrası 3,5/5 (min.0/5max.5/5) (p=0.017), non travmatik hasta grubunda ameliyat öncesi ABDF median kas gücü 2/5 (min.0/5-max.3/5) iken ameliyat sonrası 5/5 (min.4/5-max.5/5) (p=0.001). Sonuç: Çalışmamızın sonuçları, peroneal sinir dekompresyonunun geçerli ve etkili bir yöntem olduğunu göstermektedir. Non travmatik hasta grubunda daha iyi sonuçlar elde etmemize rağmen, her iki hasta popülasyonununda da dekompresyon sonrası motor fonksiyonlarında anlamlı derecede düzelme görüldü.