Pertinent Insights On Surgical Decompression For Common Peroneal Nerve Entrapment

Stephen L. Barrett, DPM, MBA, FACFAS, FAENS

   As with all lower extremity peripheral nerve surgery, nerves need to slide and glide. Nothing can destroy the ultimate outcome of peripheral nerve surgery as much as immobilization of the patient after a neurolysis.

   One can usually remove sutures at 14 days but in patients with metabolic disease, sutures can stay in as long as one month to prevent dehiscence.

In Summary

Entrapment of the common peroneal (fibular) nerve is common and we frequently only recognize it when there is severe motor loss, except in the case of the experienced practitioner who has a high degree of suspicion and clinical diagnostic acumen. Patients who present with seemingly unrelated symptoms should always have evaluation for entrapment of this nerve as physicians so commonly miss the diagnosis.

   Dr. Barrett is an Adjunct Professor in the Arizona Podiatric Medical Program at the Midwestern University College of Health Sciences. He is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Barrett is a Fellow and the incoming President of the Association of Extremity Nerve Surgeons.

   The author discloses that he is a shareholder in Sensory Management Services, which manufactures the Pressure Specified Sensory Device (PSSD).

   This article is excerpted from a chapter in the textbook “Practical Pain Management For The Lower Extremity Surgeon,” (in press) with the permission of the publisher, Data Trace.


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.

Add new comment