Common peroneal nerve injury

  The common peroneal nerve runs obliquely outward from the caddis fossa along the medial border of the biceps femoris muscle and around the fibular neck between the two heads of the peroneus longus muscle, which is divided into the superficial and deep peroneal nerves. The former travels down between the long and short fibular muscles, and the lower 1/3 of the calf penetrates the deep fascia to the medial and middle dorsum of the foot. The latter is located between the long toe extensor and the anterior tibial muscles, descends against the interosseous membrane, and accompanies the anterior tibial artery and vein to the dorsum of the foot where the thumb and long toe extensors meet. The latter is located between the interosseous membrane and descends with the anterior tibial artery and vein, and is found in the dorsum of the foot between the thumb and toe extensors. The common peroneal nerve is easily damaged at the caddis and the fibular tuberosity, resulting in paralysis of the anterolateral extensor muscles of the lower leg, dorsiflexion and valgus dysfunction of the foot, and inversion and ptosis. As well as extensor bunion, extensor toe function loss, is flexed, and the anterolateral calf and dorsalis pedis anterior, medial sensory impairment.  Etiology: 1, penetrating injury, peroneal head fracture trauma, pulling can damage the superficial peroneal nerve and deep peroneal nerve.  2, compression: the common peroneal nerve around the peroneal neck is most vulnerable to damage prolonged squatting can cause 3, lead poisoning, metabolic disorders (diabetes), connective tissue diseases (polyarteritis nodosa) and leprosy treatment: for the treatment of common peroneal nerve entrapment syndrome, mainly etiological treatment, the key lies in early diagnosis, for early consultation, the short duration of entrapment cases, are feasible conservative treatment. The method is oral glucocorticoids, vasodilators, intramuscular neurotrophic agents and with local heat, massage, physical therapy, acupuncture, etc. can be effective. For local compression or inappropriate traction, the cause of the compression should be removed immediately or the traction support should be adjusted, the head of the fibula should be suspended, and the top of the bony prominence should be removed as early as possible to release the compressed nerve. The prognosis mainly depends on the degree and duration of compression, the longer the compression time, the worse the prognosis. According to the pathological process of chronic nerve entrapment: temporary nerve ischemia → vascular nerve barrier changes → severe Wallerianqa’s degeneration. If the compression factors can be removed and the nerve can be completely released before Wallerian degeneration occurs, the function can be restored quickly and completely. If the nerve does not improve after 2-3 months of conservative treatment, then nerve exploration and release surgery should be performed. If there is no recovery, the posterior tibial muscle can be transferred or a triple joint fusion can be performed to improve function. If the sensory impairment is not in the weight-bearing area, it may not be treated.