Compression neuropathy of common peroneal nerve caused by a popliteal cyst

Zeng, Xiaobin; Xie, Lifeng; Qiu, Zhiqiang; Sun, Kuo

doi:10.1097/md.0000000000009922

Cited by 10 publications

(9 citation statements)

References 10 publications

(9 reference statements)

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“…Table 2 summarizes case reports of the cyst around knee that were previously reported according to the classification. [ 10 , 11 , 14 , 16 , 19 – 23 ] To our knowledge, our case is the first report of compressive peroneal neuropathy caused by extraneural type of ganglion cyst in the supracondylar area of femur. Ganglion cyst compressions of the peroneal nerve can be classified as intraneural or extraneural lesions.…”

Section: Discussionmentioning

confidence: 77%

Peroneal neuropathy caused by an extraneural ganglion cyst in the supracondylar area of the femur

et al. 2020

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Rationale: Peroneal neuropathy is the most common type of peripheral neuropathy in the lower extremities. The peroneal nerve is usually compressed at the lateral aspect of the fibular head. Compression by ganglion cysts are one of the numerous underlying etiologies for peroneal nerve neuropathy and are most frequently located around the fibular neck and proximal tibiofibular joint. To the best of our knowledge, this is the first report of an extraneural ganglion cyst located at the level of the distal thigh that resulted in compressive peroneal neuropathy. Patient concerns: We report a case of a 56-year-old man with sudden onset of left foot drop and gait disturbance caused by an extraneural ganglion cyst located in the popliteal fossa. Diagnosis: Electrodiagnosis (EDX) suggested a peroneal nerve lesion. Subsequently, diagnostic ultrasonography (USG) revealed a cystic mass located within the left side of the supracondylar area of femur. Further magnetic resonance imaging confirmed that the mass was located at the proximal of popliteal fossa. Interventions: Surgical excision was performed using a direct posterior approach. The cystic mass was compressing the common peroneal nerve, and was carefully and completely removed ensuring that all nerve branches were protected. Outcomes: A histopathologic evaluation confirmed the diagnosis of a ganglion cyst. There were no postoperative complications. Two months after the surgery, follow-up USG revealed no evidence of cyst recurrence or residual lesions. Six months after the surgery, the ankle dorsiflexor motor power improved and he experienced less pain and hypoesthesia. Lessons: Physicians should bear in mind that the peroneal neuropathy can occur because of the ganglion cyst in the distal thigh. The thorough evaluation of EDX and USG is crucial for the early diagnosis and surgical intervention, although there is no abnormal finding around the fibular neck.

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Section: Discussionmentioning

confidence: 77%

Peroneal neuropathy caused by an extraneural ganglion cyst in the supracondylar area of the femur

et al. 2020

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“…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

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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.

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“…CPN compression secondary to a cystic tibiofibular joint was reported in various cases. 41,[43][44][45] Two such cases described CPN compression due to intraneural ganglion and synovial cysts. 41,45 Complete return of motor function was accomplished via cyst aspiration in one case, while the other was treated with prompt surgical cyst removal and nerve decompression.…”

Section: Case Reports Common Peroneal Nervementioning

confidence: 99%

“…41,[43][44][45] Two such cases described CPN compression due to intraneural ganglion and synovial cysts. 41,45 Complete return of motor function was accomplished via cyst aspiration in one case, while the other was treated with prompt surgical cyst removal and nerve decompression. 43,44 Two other reports of cystic etiologies included an extraneural popliteal cyst and two cases of children with extraneural tibiofibular joint synovial cysts, all of which were treated with surgical cyst removal and CPN decompression.…”

Section: Case Reports Common Peroneal Nervementioning

confidence: 99%

An Update on Peroneal Nerve Entrapment and Neuropathy

et al. 2021

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Peroneal neuropathy is the most common compressive neuropathy of the lower extremity. It should be included in the differential diagnosis for patients presenting with foot drop, the pain of the lower extremity, or numbness of the lower extremity. Symptoms of peroneal neuropathy may occur due to compression of the common peroneal nerve (CPN), superficial peroneal nerve (SPN), or deep peroneal nerve (DPN), each with different clinical presentations. The CPN is most commonly compressed by the bony prominence of the fibula, the SPN most commonly entrapped as it exits the lateral compartment of the leg, and the DPN as it crosses underneath the extensor retinaculum. Accurate and timely diagnosis of any peroneal neuropathy is important to avoid progression of nerve injury and permanent nerve damage. The diagnosis is often made with physical exam findings of decreased strength, altered sensation, and gait abnormalities. Motor nerve conduction studies, electromyography studies, and diagnostic nerve blocks can also assist in diagnosis and prognosis. First-line treatments include removing anything that may be causing external compression, providing stability to unstable joints, and reducing inflammation. Although many peroneal nerve entrapments will resolve with observation and activity modification, surgical treatment is often required when entrapment is refractory to these conservative management strategies. Recently, additional options including microsurgical decompression and percutaneous peripheral nerve stimulation have been reported; however, large studies reporting outcomes are lacking.

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Compression neuropathy of common peroneal nerve caused by a popliteal cyst

Cited by 10 publications

References 10 publications

Peroneal neuropathy caused by an extraneural ganglion cyst in the supracondylar area of the femur

Peroneal neuropathy caused by an extraneural ganglion cyst in the supracondylar area of the femur

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

An Update on Peroneal Nerve Entrapment and Neuropathy

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