Useful functional recovery and quality of life after surgical treatment of peroneal nerve injuries

Abstract

Closed injuries to the peroneal nerve recover spontaneously in about a third of patients, but surgery may be needed in the remaining 2/3. The recovery after surgery is not always satisfactory and the patients may need an orthosis or a walking aid to cope with regular daily activities. This study aimed to evaluate the useful functional recovery and quality of life (QoL) in surgically treated patients with peroneal nerve (PN) injuries. The study involved 51 patients who have undergone surgical treatment due to PN injury in our department, within a 15-year period (2006–2020). Thirty patients (59%) were treated with neurolysis, 12 (23%) with nerve repair techniques, and 9 (18%) with tendon transfer (TT). Neurolysis is employed in the least extensive nerve injuries when nerve continuity is preserved and yields a motor recovery ratio of almost 80%. Nerve repairs were followed by 58.33% of patients achieving M3+ recovery, while 41.66% recovered to the useful functional state (M4 or M5) With the use of TTs, all patients recovered to the M3+, while 66.7% recovered to M4. All our results correspond to the results of previous studies. No statistically significant differences were found regarding the QoL of the groups. There is an apparent advantage of neurolysis, over nerve repair, over TT procedure, both in terms of useful functional recovery, and foot-drop-related QoL. However, when involving all aspects of QoL, these advantages diminish. The individual approach leads to optimal results in all groups of patients.

Peroneal Nerve Injury due to Hip Surgery Located at the Knee Level: A Case Report

“…Contrary to compression injuries that are easily managed by a simple surgical decompression, injuries due to traction or contusion may require more complex procedures such as tendon transfer or nerve repair. 3,20,21 Common peroneal Articular Superficial Sensory Deep Knowing the exact time of the nerve injury is important in determining the most effective surgical strategy, in terms of choosing the most appropriate procedure and setting the timing for surgery. 3,22,23 While surgical decompression is indicated after 3 months of conservative management without the signs of motor recovery, the nerve repair should not be performed later than 12 months post-injury .…”

“…3,20,21 Common peroneal Articular Superficial Sensory Deep Knowing the exact time of the nerve injury is important in determining the most effective surgical strategy, in terms of choosing the most appropriate procedure and setting the timing for surgery. 3,22,23 While surgical decompression is indicated after 3 months of conservative management without the signs of motor recovery, the nerve repair should not be performed later than 12 months post-injury . 24 On the other hand, tendon transfers are reserved for cases with poor recovery capacity due to extensive nerve injury or due to exceeding the timing for nerve repair.…”

“…24 On the other hand, tendon transfers are reserved for cases with poor recovery capacity due to extensive nerve injury or due to exceeding the timing for nerve repair. 3 Based on our experience, 3,22,23 in some cases it is difficult to determine if the injury is acquired during the trauma or during the orthopedic intervention because the patient is immobilized and unaware of the present deficit. Regarding the patient described in this paper, the hip dislocation and its repositioning could have been a cause of the palsy due to the traction and contusion of the SN.…”

“…Peroneal nerve dysfunction often referred to as common peroneal nerve (CPN) palsy presents a functional deficit, characterized by an inability to dorsiflex the foot (foot drop) with consequential disability and a significant decrease in patients' quality of life. [1][2][3] The cause of dysfunction may lie in central nerve structures, spinal nerve roots, sacral plexus, sciatic nerve (SN), the CPN, or its deep branch. 4 The incidence of CPN palsy following the most common procedure in hip surgery: the total hip arthroplasty (THA), ranged up to 8%, depending on the inclusion and exclusion criteria of the reviewed studies.…”

Post-Operative Care of the Cancer Patient: Emphasis on Functional Recovery, Rapid Rescue, and Survivorship

“…The concept is based on the resumption of several areas of normal life compared to pre-illness. These include physical [ 45 ], psychological [ 46 ], social, and economic wellbeing [ 47 ]. As a clinician, it is important to remember that different aspects of life are important to different people; this includes length of life (LoL) versus quality of life (QoL).…”