A Proximally Based Sural Fasciocutaneous Flap for the Treatment of Recurrent Peroneal Neuropathy: A Case Report

Abstract

Summary:Surgical treatment for recurrent, common peroneal neuropathy has not been reported. Herein, we describe a successfully treated case using the proximally based sural fasciocutaneous flap after reneurolysis of the adhesive common peroneal nerve. A 33-year-old man received a neurolysis operation for entrapment neuropathy of the common peroneal nerve 2 years before first admission in our clinic. Although motor nerve conduction studies showed a marked improvement after the primary operation, the patient always required the use of a crutch because of severe pain radiating to the lower leg during standing or walking. We diagnosed adhesive neuropathy of the common peroneal nerve, and performed reneurolysis by wrapping of the released nerve with a proximally based sural fasciocutaneous flap to prevent readhesion. The radiating pain was significantly reduced at 1-month postoperation. At 1-year postoperation, the patient could walk a long distance without a crutch. Wrapping the released common peroneal nerve with a proximally based sural fasciocutaneous flap is a useful option for the treatment of recurrent, common peroneal neuropathy.

One‐stage Neurorrhaphy and Posterior Transposition with Gastrocnemius Fascial Flap for Common Peroneal Nerve Injury: Preliminary Results

“…11 The results showed that the patient experienced a good functional recovery after the surgery. 11 Moreover, wrapping the released CPN using a sural fasciocutaneous flap may help prevent postoperative readhesion. 11 With regards to the aforementioned findings, we proposed two hypotheses to explain why CPN repairs fail based on our recent clinical experience: first, a CPN injury is typically superficial, and the nerve bed experiences a suboptimal nutritional environment, thus making it prone to entrapment and challenging to recover from.…”

“…The results showed that the patient experienced a good functional recovery after the surgery 11 . Moreover, wrapping the released CPN using a sural fasciocutaneous flap may help prevent postoperative re‐adhesion 11 …”

“…11 Moreover, wrapping the released CPN using a sural fasciocutaneous flap may help prevent postoperative readhesion. 11 With regards to the aforementioned findings, we proposed two hypotheses to explain why CPN repairs fail based on our recent clinical experience: first, a CPN injury is typically superficial, and the nerve bed experiences a suboptimal nutritional environment, thus making it prone to entrapment and challenging to recover from. Particularly, the CPN is positioned superficially at the fibular neck and fibular tunnel, where it receives an inadequate blood supply and is situated posteriorly to the popliteal fossa.…”

“…reported a case of a patient with CPN injury who underwent neurolysis combined with wrapping of the released CPN using a sural fasciocutaneous flap 11 . The results showed that the patient experienced a good functional recovery after the surgery 11 . Moreover, wrapping the released CPN using a sural fasciocutaneous flap may help prevent postoperative re‐adhesion 11 …”

“… 11 Moreover, wrapping the released CPN using a sural fasciocutaneous flap may help prevent postoperative re‐adhesion. 11 …”