title: Entrapment of the deep peroneal nerve and anterior tibial vessels by a spiral tibial fracture causing partial non-union: a case report.
abstract: We report a case of entrapment of the deep peroneal nerve as well as the anterior tibial artery and vein by a spiral distal tibial shaft fracture, causing partial non-union. The authors describe the utility of MRI in making the diagnosis of this post-traumatic complication, which may potentially result in a permanent neurovascular deficit and adverse functional outcome if left undetected. The importance of recognizing the distinct possibility of entrapment and injury to the deep peroneal nerve as well as the anterior tibial vessels, when managing a fracture involving the distal third of the tibial shaft is emphasized. Absence of clinical symptoms or signs of neurovascular entrapment should not deter one from performing the relevant investigations to exclude this complication, in particular when surgical fixation is being contemplated, or in the presence of a non-healing fracture.
authors.affiliation: Department of Radiology, Changi General Hospital, Singapore, Singapore.
authors.forename: Evan Tai Long
authors.initials: ET
authors.lastname: Tan
authors.affiliation: Department of Radiology, Changi General Hospital, Singapore, Singapore. tien_jin_tan@cgh.com.sg.
authors.forename: Tien Jin
authors.initials: TJ
authors.lastname: Tan
authors.affiliation: Department of Orthopaedic Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: Kein Boon
authors.initials: KB
authors.lastname: Poon
mesh_terms: D000328:Adult; D005260:Female; D005599:Fractures, Ununited / Q000150:complications* / Q000000981:diagnostic imaging* / Q000534:rehabilitation; D006801:Humans; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000534:rehabilitation; D010543:Peroneal Nerve / Q000000981:diagnostic imaging* / Q000293:injuries*; D016909:Tibial Arteries / Q000000981:diagnostic imaging* / Q000293:injuries*; D013978:Tibial Fractures / Q000150:complications* / Q000000981:diagnostic imaging* / Q000534:rehabilitation
keywords: Magnetic resonance imaging; Nerve compression syndromes; Peroneal nerve; Tibial arteries; Tibial fractures