1. Complete formal peripheral nerve surgery training
2. Use of 3-4x surgical loupes (preferably with headlight)
3. Avoidance of monopolar cautery
4. Immediate mobilization after surgery
5. Use of blunt dissection only once through the skin
6. Use of extreme care when entering and dissecting in the lateral compartment
7. Precise incision placement
8. Patient positioning with a flexed knee position
9. Understand that there is a “learning curve” and that working with an experienced surgical mentor during the initial cases can accelerate competence
Pertinent Insights On Surgical Decompression For Common Peroneal Nerve Entrapment
- Volume 26 - Issue 12 - December 2013
- 29126 reads
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1. Campbell WW. Diagnosis and management of common compression and entrapment neuropathies. Neurol Clin. 1997; 15(3):549-567.
2. Damarey B, Demondion X, Wavreille G, Pansini V, Balbi V, Cotten A. Imaging of the nerves of the knee region. Eur J Radiol. 2013; 82(1):27-37.
3. Anselmi SJ. Common peroneal nerve compression. J Am Podiatr Med Assoc. 2006; 96(5):413-417.
4. Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Peroneal nerve entrapment. J Bone Joint Surg Am. 1998; 80(1):47-53.
5. Mont MA, Dellon AL, Chen F, Hungerford MW, Krackow KA, Hungerford DS. The operative treatment of peroneal nerve palsy. J Bone Joint Surg Am. 1996; 78(6):863-869.
6. Colak T, Bamac B, Gonener A, Ozbek A, Budak F. Comparison of nerve conduction velocities of lower extremities between runners and controls. J Sci Med Sport. 2005; 8(4):403-410.
7. Crotti FM, Carai A, Carai M, Sgaramella E, Sias W. Entrapment of crural branches of the common peroneal nerve. Acta Neurochir Suppl. 2005; 92:69-70.
8. Canale ST (ed.). Campbell’s Operative Orthopedics, ninth edition, Mosby, St. Louis, 1998.
9. Sidey JD. Weak ankles. A study of common peroneal entrapment neuropathy. Br Med J. 1969; 3(5671):623-626.
10. Dellon AL, Muse VL, Scott ND, et al. A positive Tinel sign as predictor of pain relief or sensory recovery after decompression of chronic tibial nerve compression in patients with diabetic neuropathy. J Reconstr Microsurg. 2012; 28(4):235-240.
11. Lee CH, Dellon AL. Prognostic ability of Tinel sign in determining outcome for decompression surgery in diabetic and nondiabetic neuropathy. Ann Plast Surg. 2004; 53(6):523-527.
12. Ferreira M, Vieira, SAT, Carvalho, VF. Comparative study of the sensitivity of diabetic lower extremities with and without ulcers using the PSSD. Acta Ortop Bras [online] 2010; 18(2):71-74.
13. Tassler PL, Dellon AL. Correlation of measurements of pressure perception using the Pressure-Specified Sensory Device with electrodiagnostic testing. J Occup Environ Med. 1995; 37(7):862-866.
14. Calvet JH, Dupin J, Winiecki H, Schwarz PE. Assessment of small fiber neuropathy through a quick, simple and non invasive method in a German diabetes outpatient clinic. Exp Clin Endocrinol Diabetes. 2013; 121(2):80-83.
15. Onde ME, Ozge A, Senol MG, et al. The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy. J Int Med Res. 2008; 36(1):63-70.
Editor’s note: For further reading, see Dr. Barrett’s DPM Blogs, “Overcoming Podiatric Dogma On Neuromas And Peripheral Nerve Surgery” at http://tinyurl.com/lpjnrkt, “Avoiding Crippling Cases Of Drop Foot With Early Diagnosis” at http://tinyurl.com/lrqzer3 or “Peering Into The Crystal Ball: When Will The Podiatry Profession Shake Free Of Dogma When It Comes To Nerves?” at http://tinyurl.com/l7zd74q .