Risk Factors for Peroneal Nerve Injury and Recovery in Knee Dislocation

Peskun, Christopher; Chahal, Jas; Steinfeld, Zvi Y.; Whelan, Daniel B.

doi:10.1007/s11999-011-1981-0

Cited by 80 publications

(100 citation statements)

References 21 publications

(26 reference statements)

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“…This compares favorably to the previously reported nerve recovery rates (31%-75%) [2,11,23,24,27]. The variability of the existing literature likely results from injury heterogeneity and the definition of ''recovery.''…”

Section: Discussionsupporting

confidence: 78%

“…The variability of the existing literature likely results from injury heterogeneity and the definition of ''recovery.'' For example, Peskun et al [23] report a 31% recovery rate in their series of 26 peroneal nerve palsies with knee dislocation but defined recovery as full strength and sensation. Similarly, Niall et al [22] demonstrated complete motor recovery in 21% but partial recovery in only 29%.…”

Section: Discussionmentioning

confidence: 99%

“…Motor examination grading was standardized as previously described [4]. Complete nerve palsy was defined as 0/5 tibialis anterior (TA) strength and 0/5 extensor hallucis longus (EHL) strength and complete sensation loss as previously described [23]. Partial nerve palsy was defined as a deficit in at least one of the following measures: TA strength or EHL strength or peroneal nerve sensation (or any combination).…”

Section: Methodsmentioning

confidence: 99%

“…One previous study demonstrated that increased body mass index and male sex are associated with increased risk of peroneal nerve injury with multiligament knee injury, and young age is a favorable prognostic factor for recovery [23]. However, the authors in that report did not categorize nerve palsies into complete versus incomplete injuries, which limits the ability to assess injury severity and subsequent nerve-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…The peroneal nerve is at risk because it is held tightly against the fibular head [11] and injury often is associated with proximal fibular fractures and posterolateral corner injuries [5,17]. Recovery of nerve injury is variable, reported as ranging from 31% to 75% [2,11,23,24,27]. However, morbidity associated with persistent nerve dysfunction and foot drop is considerable [3].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Krych

Giuseffi

Kuzma

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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BackgroundPeroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury-with or without complete recovery-is a predictor of inferior patient-reported outcome scores. Questions/purposes The purposes of this study were to (1) report on motor and sensory recovery as well as patientreported outcomes scores of patients with peroneal nerve injury from multiligament knee dislocation; (2) compare those endpoints between patients who had partial versus complete nerve injuries; and (3) compare patient-reported outcomes among patients who sustained peroneal nerve injuries after knee dislocation with a matched cohort of multiligament knee injuries without nerve injury. Methods Thirty-two patients were identified, but five did not have 2-year followup and are excluded (16% lost to followup). Twenty-seven patients (24 male, three female) with peroneal nerve injury underwent multiligament knee reconstruction and were followed for 6.3 years (range, 2-18 years). Motor grades were assessed by examination and outcomes by International Knee Documentation Committee (IKDC) and Lysholm scores. Retrospectively, patients were divided into complete (n = 9) and partial nerve palsy (n = 18). Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex. Data were analyzed using univariate and multivariate models. Results Overall, 18 patients (69%) regained antigravity ankle dorsiflexion after treatment (three complete nerve palsy [38%] versus 15 partial nerve palsy [83%]; p = 0.06). One patient with complete nerve palsy (13%) and 13 patients with partial nerve palsy (72%) regained antigravity extensor hallucis longus strength (p = 0.01). IKDC and Lysholm scores were similar between complete nerve palsy and partial nerve palsy groups. After controlling for confounding variables such as patient age, body mass index, injury interval to surgery, mechanism of injury, bicruciate injury, and popliteal artery injury status, there was no difference between patients with peroneal nerve injury and those without on Lysholm or IKDC scores.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%