Peroneal nerve paralysis: Characteristics and therapeutic results of eight operated cases

Objective: Peroneal nerve paralysis is one of the peripheral nerve lesions often seen in the lower limb. In this paper, characteristics and surgical treatment results of eight cases in whom peroneal nerve injury developed due to mechanical, traumatic and postural reasons were investigated.
Material and Method: Between April 2011 and November 2013, eight patients who referred to our clinic due to lower leg related to peroneal nerve injury were treated. In order to diagnose the illness and determine the level of injury, electromyography (EMG) and neural transmission speed study were carried out on all patients. During motor assessment, strong sides of patients were compared.
Results: Six of the patients were men and 2 of them were women, and average age was 41.9±4.2 (range: 23-72). One of the patients had an ankle sprain history, two of them had a history of long term practice by falling on their knees, in two a history of wearing top boots or wellies, in other two patients a history of waiting for hours by crossing their legs, and one patient had a trauma history on knee-joint level after a traffic accident. Average duration of symptoms and findings were 3.8 months (range: 3-6 months) A very serious slowness in the transmission speed and an amplitude block were seen in main peroneal nerve and at a level of fibular head during the EMG done to the patients. All the patients were treated at the level of fibular head by doing peroneal nerve decompression.
Conclusion: Peroneal nerve is usually pinched in fibular head or neck side. In the cases not responding to conservative treatments, satisfactory results are generally obtained by freeing of nerve at fibular head level.

Peroneal sinir felci: Ameliyat edilen sekiz olgunun özellikleri ve tedavi sonuçlarý

Amaç: Peroneal sinir felci alt ekstremitede sýk görülen periferik sinir lezyonlarýndan biridir. Bu yazýda, mekanik, travma ve postural nedenlerle peroneal sinir yaralanmasý geliþen sekiz olgunun özellikleri ve cerrahi tedavi sonuçlarý incelendi.
Gereç ve Yöntem: Nisan 2011- Kasým 2013 tarihleri arasýnda peroneal sinir yaralanmasýna baðlý düþük ayak nedeniyle kliniðimize baþvuran sekiz hasta tedavi edildi. Hastalarýn hepsinde taný koyma ve yaralanma düzeyinin belirlenmesi amacýyla elektromiyografi (EMG) ve sinir ileti hýzý çalýþmalarý yapýldý. Motor deðerlendirmede hastalarýn saðlam taraflarý ile karþýlaþtýrma yapýldý.
Bulgular: Hastalarýn altýsý erkek ikisi bayan olup ortalama yaþ 41.9±4.2 (aralýk: 23-72) idi. Hastalarýn birinde ayak bileði burkulmasý, ikisinde dizleri üzerine çömelip saatlerce çalýþma, iki hastada uzun çizme veya bot giyme, iki hastada bacak bacak üstüne atýp saatlerce bekleme ve bir hastada trafik kazasý sonrasý diz eklemi düzeyinde travma öyküsü vardý. Semptom ve bulgularýn süresi ortalama 3.8 ay (aralýk: 3-6 ay) idi. Hastalara yapýlan EMG’de ana peroneal sinirde fibula baþý düzeyinde iletim hýzýnda ciddi yavaþlama ve amplitüd bloðu görüldü. Tüm hastalar fibula baþý hizasýnda peroneal sinir dekompresyonu yapmak suretiyle tedavi edildi.
Sonuç: Peroneal sinir genellikle fibula baþý veya boyun kýsmýnda sýkýþýr. Konservatif tedavilere yanýt vermeyen olgularda sinirin fibula baþý seviyesinde serbestleþtirilmesi ile genellikle tatminkar sonuçlar edilir.