Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center.
OBJECTIVE
This study analyzes 318 operative knee-level common peroneal nerve lesions managed at the Louisiana State University Health Sciences Center between 1967 and 1999.


METHODS
Each patient was retrospectively evaluated for injury mechanism, preoperative neurological status, electrophysiological studies, lesion type, and operative technique, i.e., neurolysis, suture, or graft repair. All lesions in continuity had intraoperative nerve action potential recordings.


RESULTS
There were 141 stretch/contusions without fracture/dislocations (44%), 39 lacerations (12%), 40 tumors (13%), 30 entrapments (9%), 22 stretch/contusions with fracture/dislocations (7%), 21 compressions (7%), 13 iatrogenic injuries (4%), and 12 gunshot wounds (4%). After neurolysis, 107 (88%) of 121 knee-level common peroneal nerve lesions with recordable intraoperative nerve action potentials recovered useful function. Nineteen patients underwent end-to-end suture repair, and 16 (84%) of these achieved good recovery by 24 months. Graft repair was performed in 138 peroneal injuries. Thirty-six patients (26%) had grafts less than 6 cm long, of which 27 (75%) achieved Grade 3 or greater peroneal function. Twenty-four (38%) of 64 patients with 6- to 12-cm grafts, and only 6 (16%) of 38 patients with 13- to 24-cm grafts, attained good peroneal function. Longer grafts correlated with more severe injuries and thus poorer outcomes. Thirty-two (80%) of 40 tumors were resected with preservation of preoperative clinical function.


CONCLUSIONS
Surgical exploration and repair of peroneal nerve lesions achieved good results with timely operations and thorough intraoperative evaluations. Useful function was achieved in 27 (75%) of 36 patients with grafts less than 6 cm in length and in only 88 (44%) of 202 patients with grafts greater than 6 cm in length.
Kim
Daniel H
DH
Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305-5327, USA. neurokim@stanford.edu
Murovic
Judith A
JA
Tiel
Robert L
RL
Kline
David G
DG
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008145:Louisiana; D008875:Middle Aged; D009463:Neuroma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D010524:Peripheral Nervous System Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010543:Peroneal Nerve / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D020427:Peroneal Neuropathies / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome