High-Stepping Cross-Country Athlete: A Unique Case of Foot Drop and a Novel Treatment Approach

Tabor, Melissa; Emerson, Blaze; Drucker, Rebecca; Brunk, Eric

doi:10.1249/jsr.0000000000000396

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…Hydrodissection involves injection of a nonirritating solution around a nerve to reduce compression from surrounding tissue. 4 It has been medically utilized in a variety of ways, including in dissection, breast reconstruction, and ophthalmology. 5,6 It has also been used with ultrasound guidance in peripheral nerve entrapment with two goals: (1) to restore function to the nerve and (2) to release soft tissue adhesions causing entrapment.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 It has also been used with ultrasound guidance in peripheral nerve entrapment with two goals: (1) to restore function to the nerve and (2) to release soft tissue adhesions causing entrapment. 4,5,7 Methods differ, and saline, anesthetics, steroids, platelet-rich plasma, and dextrose have all been utilized to varying efficacy. 8 While a relative paucity of cases have specifically reported hydrodissection of the peroneal nerve, the procedure has been described as successful in other neuropathies.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Magnetic resonance imaging (MRI) is the standard for diagnosis of peroneal nerve palsies in the lower extremity, but electromyography and nerve conduction studies are also helpful. 2,4 Treatment of peroneal nerve neuropathies has historically been surgical, involving dissection and decompression. 4 However, recurrence rates after surgery can reach as high as 30% and can be complicated by neurovascular damage.…”

mentioning

confidence: 99%

“…2,4 Treatment of peroneal nerve neuropathies has historically been surgical, involving dissection and decompression. 4 However, recurrence rates after surgery can reach as high as 30% and can be complicated by neurovascular damage. 4…”

mentioning

confidence: 99%

“…4 However, recurrence rates after surgery can reach as high as 30% and can be complicated by neurovascular damage. 4…”

mentioning

confidence: 99%

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Hydrodissection as a therapeutic and diagnostic modality in treating peroneal nerve compression

Song

Marathe

Chi

et al. 2020

Baylor University Medical Center Proceedings

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A 51-year-old man presented with pain in the region of his left patellar tendon and fibular head. He had previously undergone three L5 epidural steroid injections and physical therapy without relief. Prior magnetic resonance imaging was significant only for fat pad impingement, and electromyography and nerve conduction studies were negative. Ultrasound demonstrated an enlarged peroneal nerve suggestive of peroneal nerve entrapment. Three ultrasound-guided hydrodissection procedures offered symptomatic improvement and identified an area posterior to the fibular head that was unable to be hydrodissected, indicating scar tissue causing peroneal nerve compression. The patient was referred for peroneal nerve decompression at the area of entrapment with complete symptom relief. This case is unique in describing the ability of hydrodissection to identify nerve compression not visualized with other diagnostic tests.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…4 However, recurrence rates after surgery can reach as high as 30% and can be complicated by neurovascular damage. 4…”

mentioning

confidence: 99%

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Hydrodissection as a therapeutic and diagnostic modality in treating peroneal nerve compression

Song

Marathe

Chi

et al. 2020

Baylor University Medical Center Proceedings

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Ulnar Nerve Entrapment at the Cubital Tunnel Successfully Treated with Ultrasound-Guided Peripheral Nerve Hydrodissection: A Case Report and Further Evidence for a Developing Treatment Option

Stoddard

Taylor

O’Connor

2019

Curr Sports Med Rep

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Peroneal nerve palsy (injury) in fibullar tunnel syndrome

Luneva

Гришина

Супонева

2022

Neuromuscular Diseases

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While compression neuropathies of the nerves of the lower limbs are not a common pathology, peroneal nerve neuropathy is the most common of them. Peroneal nerve compression most commonly occurs at or around the head of the fibula, but can also occur in the lower leg, ankle, or foot. Neurophysiological and neuroimaging methods are effective in diagnosing peroneal nerve compression and determining the type of damage. The first line of therapy is lifestyle modification, avoidance of compressive postures, ankle joint orthotics, treatment of knee joint instability when detected, kinesiotherapy. An important role in the correction of symptoms is played using anticholinesterase drugs, the effectiveness of which in diseases of peripheral nervous system has been shown in a number of domestic studies. If conservative treatment fails, surgical treatment is recommended. The diagnosis of peroneal neuropathy is associated with a good prognosis and most patients experience complete recovery of nerve function.

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High-Stepping Cross-Country Athlete: A Unique Case of Foot Drop and a Novel Treatment Approach

Cited by 3 publications

References 11 publications

Hydrodissection as a therapeutic and diagnostic modality in treating peroneal nerve compression

Hydrodissection as a therapeutic and diagnostic modality in treating peroneal nerve compression

Ulnar Nerve Entrapment at the Cubital Tunnel Successfully Treated with Ultrasound-Guided Peripheral Nerve Hydrodissection: A Case Report and Further Evidence for a Developing Treatment Option

Peroneal nerve palsy (injury) in fibullar tunnel syndrome

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