ETIOLOGY AND SURGICAL-TREATMENT OF COMMON FIBULAR NERVE LESIONS - A 146 CASES REPORT

Purpose of the study Common peroneal nerve lesion on the lateral aspec t of the knee is one of the most frequent neurologic injury of the low er limb. We reported the results of surgical procedure for each etiolo gical group. Material and methods In the peroneal nerve entrapment gro up, we individualised 62 fibular tunnel syndroms (55 idiopathic, 4 pos tural, 3 dynamic), and 16 external compression. Traumatic causes were represented by 22 varus injuries of the knee and by 11 fractures, 16 i atrogenic lesions, 2 wounds, 5 wound sequelae, 2 contusions and 1 burn . Tumoral group was represented by 7 intraneural ganglionic cyst and 2 extraneural tumour (1 exostosis and 1 chondromatosis of the proximal tibio fibular joint). All patients underwent surgical procedure. Neuro lysis was performed when the nerve was in continuity. Suture or nerve grafting was performed in the other cases. In the case of intraneural ganglionic cyst, a complete tumoral excision was realised. Results Eig hty-three per cent of excellent and good results were obtained for the fibular tunnel syndrom, 62,5 per cent for external compression, 36 pe r cent for varus injury of the knee, 78 per cent for the other traumat ic causes and 89 per cent for tumoral lesions. Discussion This report confirms that the result depends on the etiology of the common peronea l nerve lesion. We propose surgical treatment within 2 to 4 months for the patients without clinical and electrophysiological improvement. I f there is doubt on the continuity of the nerve, we propose an earlier surgical treatment. Our results were in general satisfactory except w hen a nerve graft was necessary futhermore if it was a traction injury and if the length of the graft was longer than 6 centimeters.