THE OPERATIVE TREATMENT OF PERONEAL NERVE PALSY

We retrospectively reviewed the results of operative decompression for peroneal nerve palsy in thirty-one patients, who had been managed bet ween 1980 and 1990, All patients had been managed nonoperatively for a t least two months after they had initially been seen, Intraoperativel y, we found epineurial fibrosis and bands of fibrous tissue constricti ng the peroneal nerve at the level of the fibular head and at the prox imal origin of the peroneus longus muscle, At a mean of thirty-six mon ths (range, twelve to seventy-two months) postoperatively, thirty (97 per cent) of the thirty-one patients reported subjective and functiona l improvement and were able to discontinue the use of the ankle-foot o rthosis, In contrast, only three of nine patients who had been managed non-operatively reported subjective and functional improvement (p < 0 .01). Peroneal nerve palsy does not always resolve spontaneously; if i t is left untreated, the loss of dorsiflexion of the ankle and persist ent paresthesias can result in severe functional disability, Therefore , if nonoperative measures do not lead to improvement within two month s, we believe that operative decompression should be considered.