The common peroneal nerve represents a major nerve terminal of the sciatic nerve
aetiology ( peroneal nerve lesions) (2)
Peroneal nerve is the most commonly damaged nerve in the lower limb and is relatively unprotected as it traverses the lateral aspect of the head of the fibula.
Damage of the nerve may occur due to various reasons:
- acute trauma
- may result from - direct blows and lacerations, severe adduction injuries and dislocations of the knee, fractures of the head or neck of the fibula, and bullet wounds
- external pressure
- most frequent cause of peroneal neuropathy
- caused by
- nerve compression as a result of sleeping in an abnormal position
- weight loss and pressure caused by hard hospital mattresses or bed railings as seen in bed ridden and comatose patients
- plaster casts and leg braces
- sitting cross-legged – in habitual leg crossers
- squatting or kneeling for a long period of time e.g - farm labourers and other workers such as carpet layers
- injury during knee operations, including total knee replacement and arthroscopic surgery
- masses e.g. - a ganglion arising from the superior tibiofibular joint, Baker’s cysts etc
- mononeuropathy multiplex syndromes
- idiopathic causes
Clinical features include:
Recovery occurs within a few weeks when the cause is simple compression. Full knee flexion should be avoided as in kneeling or squatting, and the patient should not sit with the legs crossed over the unaffected leg. To prevent foot drop the patient should wear an aluminium night-shoe at night and during the day, a shoe with plastic inserts.
Surgical exploration is indicated if the weakness progresses or fails to resolve within 1-2 months, or if there is an obvious local lesion.
Last reviewed 01/2018