title: Deep peroneal nerve palsy with isolated lateral compartment syndrome secondary to peroneus longus tear: a report of two cases and a review of the literature.
abstract: Drop foot is typically caused by neurologic disease such as lumbar disc herniation, but we report two rare cases of deep peroneal nerve palsy with isolated lateral compartment syndrome secondary to peroneus longus tears. Both patients developed mild pain in the lower legs while playing sport, and were aware of drop foot. As compartment pressures were elevated, fasciotomy was performed immediately, and the tendon of the peroneus longus was completely detached from its proximal origin. The patients were able to return their original sports after 3 months, and clinical examination revealed no hypesthesia or muscle weakness in the deep peroneal nerve area at the time of last follow-up. The common peroneal nerve pierced the deep fascia and lay over the fibular neck, which formed the floor of a short tunnel (the so-called fibular tunnel), then passed the lateral compartment just behind the peroneus longus. The characteristic anatomical situation between the fibular tunnel and peroneus longus might have caused deep peroneal nerve palsy in these two cases after hematoma adjacent to the fibular tunnel increased lateral compartment pressure.
authors.affiliation: Department of Orthopaedic Surgery, Yao Municipal Hospital, 1-3-1, Ryugecho, Yao, Osaka, Japan. k-hiramatsu@umin.ac.jp.
authors.forename: Kunihiko
authors.identifier: http://orcid.org/0000-0002-2239-873X
authors.initials: K
authors.lastname: Hiramatsu
authors.affiliation: Department of Orthopaedic Surgery, Hoshigaoka Medical Center, 4-8-1, Hoshigaoka, Hirakata, Osaka, Japan.
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Yonetani
authors.affiliation: Department of Orthopaedic Surgery, Hoshigaoka Medical Center, 4-8-1, Hoshigaoka, Hirakata, Osaka, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kinugasa
authors.affiliation: Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.|Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, 4-14-1, Shibahara, Toyonaka, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
authors.affiliation: Department of Orthopaedic Surgery, Hoshigaoka Medical Center, 4-8-1, Hoshigaoka, Hirakata, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hamada
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications* / Q000601:surgery*; D001484:Baseball / Q000293:injuries; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery*; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010243:Paralysis / Q000209:etiology / Q000601:surgery; D010543:Peroneal Nerve / Q000293:injuries*; D012421:Rupture; D012916:Soccer / Q000293:injuries; D013708:Tendon Injuries / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult
keywords: Deep peroneal nerve palsy; Lateral compartment syndrome; Peroneus longus tear