OVERVIEW
OVERVIEW
Damage to the common peroneal nerve is caused by penetrating injury, fracture of the fibular head, metabolic disorders, compression, trauma and other factors. The main manifestations are foot drop, walking in a straddling gait; inability to dorsiflexion and valgus of the ankle joint, inability to dorsiflexion of the toes; loss of skin sensation on the outside of the calf and the dorsum of the foot; and muscular atrophy of the anterior tibial and lateral calf muscles.
Whether medical insurance
Yes
Department
Neurology, Neurosurgery, Orthopedics, Endocrinology
Clinical symptoms
Foot drop, walking in a straddling gait, decreased or absent skin sensation on the lateral calf and dorsum of the foot, atrophy of the anterior tibial and lateral calf muscles, etc.
Harmful effects
It may cause sensory and motor abnormalities, such as gait abnormality, loss of skin sensation on the back of the foot, and muscle atrophy.
Examination
Physical examination, neuromuscular electromyography, X-ray examination, etc.
Diagnosis
Diagnosis is based on the history of the disease, gait abnormality, loss of sensation on the dorsal surface of the foot, combined with physical examination and neuromuscular electromyography.
Treatment principle
Treatment of the cause of the disease and drug treatment in the acute stage; patients with complete paralysis in the recovery stage can be corrected surgically.
Curability
Active treatment can effectively improve the symptoms.
Dietary recommendations
Give high protein, high vitamin diet.
Etiology
Etiology
Can be caused by penetrating injuries, fibular head fractures, lead poisoning, stress, metabolic disorders (e.g., diabetes), and connective tissue diseases.
Symptoms and Diagnosis
Typical symptoms
It can cause atrophy and weakness of the gastrocnemius muscle, weakness of the ankle valgus, weakness of the anterior tibialis muscle group, weakness of dorsiflexion of the ankle and toes, and atrophy and weakness of the dorsal phalanges on the back of the foot. It may be characterized by foot drop and walking in a straddling gait. The ankle joint is unable to dorsiflex and valgus, and the toes are unable to dorsiflex. Lateral calf and dorsal foot skin sensation is reduced or absent. Atrophy of the anterior tibial and lateral calf muscles.
Diagnostic basis
1. A clear history of penetrating injury, fibular head fracture, lead poisoning, compression and diabetes mellitus and connective tissue disease.
2. Clinical manifestations such as foot drop, walking in a straddling gait, decreased or absent sensation of the lateral calf and dorsum of the foot, and atrophy of the anterior tibial and lateral calf muscles.
3. If necessary, the neuromuscular examination can help to determine the site of nerve injury, and provide a basis for judging the degree of injury, prognosis and observation of nerve regeneration.
Treatment
Treatment guideline
In the acute stage, glucocorticosteroids such as prednisone and dexamethasone can be used as intravenous drip or localized closure; neurotrophic drugs such as B vitamins and nerve growth factor can be used. In the recovery period, closed, physical therapy and surgery are used as appropriate.
Drug treatment
In order to promote the recovery of nerve function, B vitamins can be given.
Surgery
If the function of complete paralysis is not restored by conservative treatment, tendon displacement or ankle fusion can be performed to correct foot drop deformity in the late stage.
Other treatments
In order to promote the recovery of nerve function can be given to physical therapy, electrical stimulation, acupuncture, body therapy and other treatments. Ptosis can be closed locally, such as using 2% procaine in the anterior side of the head of the fibula Yanglingquan point closed; can also be used to close the Garland Tamin, to promote muscle recovery. Acupuncture, physiotherapy and drug iontophoresis can also be used. Peroneal nerve palsy produces inversion pendulous foot, can wear calf orthosis or wear corrective shoes.
Prognosis
Aggressive treatment can effectively improve the prognosis.
Questions you may be concerned about
How to treat peroneal nerve damage after trauma to the left foot?
Peroneal nerve damage after trauma to the left foot can be treated with exercise, physical therapy and medication, or surgery if treatment is not effective.
After the peroneal nerve injury, it will cause the weakness of lifting the back of the foot to walk and fall easily, and the nerve function can be stimulated to recover by strengthening the functional exercise, such as active contraction of the posterior calf muscles, passive flexion and extension of the ankle joint and other stimulation. Electroacupuncture can also be used to stimulate the recovery of nerve function. Neurotrophic drugs such as methylcobalamin and adenosylcobalamin can also be taken orally.
If the nerve function is still not restored after a long period of treatment, surgery can be chosen. Nerve anastomosis or nerve transplantation can be chosen if the nerve is severed. Posterior tibialis muscle transposition can also be chosen for treatment.
If there are symptoms of peroneal nerve injury after trauma to the left foot, it is recommended that the patient go to the hospital for medical examination and symptomatic treatment after perfect examination. The above drugs need to be used under the guidance of a doctor, avoid self-medication.
Nursing care
Daily care
Keep the indoor air fresh and open the windows regularly for ventilation.
Patients insist on limb function exercise and daily life activities.
Live a regular life, take reasonable rest, and ensure sleep time and sleep quality.
4. Family members patiently listen to the patient’s inner thoughts, respect and understand the patient’s inner feelings, and give positive psychological support. Patients should relax, reduce psychological pressure, keep cheerful and open-minded, and avoid emotional tension.
5. After discharge from the hospital, follow the doctor’s instructions for regular rechecking, and consult the doctor promptly if any abnormality is found.
Dietary management
Eat more high-protein, high-vitamin food.