Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants’ data

Klifto, Kevin M.; Azoury, Saïd C.; Gurno, Caresse F.; Card, Elizabeth B.; Levin, L. Scott; Kovach, Stephen J.

doi:10.1016/j.bjps.2021.09.040

Cited by 7 publications

(2 citation statements)

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“…Each treatment method was selected based on the etiology and severity of the patient’s injury, acknowledging that the right treatment approach can vary significantly depending on these factors. Patients with CPN transection or traction injuries can be considered for tendon transfer, while those with CPN rupture may benefit from nerve graft or tendon transfer and those with CPN compression are often considered for neurolysis [ 25 ]. However, in cases of cut traumas, intraoperative exploration has sometimes revealed CPN continuity.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes of different surgical treatments for common peroneal nerve injuries: a retrospective comparative study

Pang,

Zhu,

Shen

et al. 2024

BMC Surg

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Background This study aims to assess the recovery patterns and factors influencing outcomes in patients with common peroneal nerve (CPN) injury. Methods This retrospective study included 45 patients with CPN injuries treated between 2009 and 2019 in Jing’an District Central Hospital. The surgical interventions were categorized into three groups: neurolysis (group A; n = 34 patients), nerve repair (group B; n = 5 patients) and tendon transfer (group C; n = 6 patients). Preoperative and postoperative sensorimotor functions were evaluated using the British Medical Research Council grading system. The outcome of measures included the numeric rating scale, walking ability, numbness and satisfaction. Receiver operating characteristic (ROC) curve analysis was utilized to determine the optimal time interval between injury and surgery for predicting postoperative foot dorsiflexion function, toe dorsiflexion function, and sensory function. Results Surgical interventions led to improvements in foot dorsiflexion strength in all patient groups, enabling most to regain independent walking ability. Group A (underwent neurolysis) had significant sensory function restoration (P < 0.001), and three patients in Group B (underwent nerve repair) had sensory improvements. ROC analysis revealed that the optimal time interval for achieving M3 foot dorsiflexion recovery was 9.5 months, with an area under the curve (AUC) of 0.871 (95% CI = 0.661–1.000, P = 0.040). For M4 foot dorsiflexion recovery, the optimal cut-off was 5.5 months, with an AUC of 0.785 (95% CI = 0.575–0.995, P = 0.020). When using M3 toe dorsiflexion recovery or S4 sensory function recovery as the gold standard, the optimal cut-off remained at 5.5 months, with AUCs of 0.768 (95% CI = 0.582–0.953, P = 0.025) and 0.853 (95% CI = 0.693–1.000, P = 0.001), respectively. Conclusions Our study highlights the importance of early surgical intervention in CPN injury recovery, with optimal outcomes achieved when surgery is performed within 5.5 to 9.5 months post-injury. These findings provide guidance for clinicians in tailoring treatment plans to the specific characteristics and requirements of CPN injury patients.

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