INTERFASCICULAR RECONSTRUCTION OF THE PERONEAL NERVE AFTER KNEE LIGAMENT INJURY

Peroneal palsy is the most common lower extremity nerve injury. Althou gh most studies emphasize particularly poor prognosis after traction i njuries to the peroneal nerve, interfascicular nerve grafting has emer ged as a promising technique. We describe the case of a 20-year-old ma n who sustained a traction injury to the peroneal nerve (0/5 foot dors iflexion and eversion) concomitant with tears of the anterior cruciate and lateral collateral ligaments. Interfascicular sural nerve graftin g (10-14 cm in length) was performed 7 months after injury and 6 month s after ligament reconstruction. The patient recovered motor strength (4+/5) in both anterior and lateral compartments by 2 years' postsurge ry. The results obtained indicate that interfascicular nerve grafting is a valuable technique for reconstruction of the disrupted peroneal n erve; it provides sufficient benefit to justify the time, expense, and effort involved. An aggressive approach is thus recommended in patien ts with peroneal nerve disruption in the setting of multiple knee liga ment injuries.