Tension neuropathy of the superficial peroneal nerve: Associated conditions and results of release

We reviewed eight patients who sustained superficial peroneal nerve neuralg ia after an inversion ankle sprain. Surgical exploration found anatomic abn ormalities that tethered the nerve from movement during plantarflexion and inversion of the ankle. Most patients' pain improved dramatically after rel ease and anterior transposition of the nerve. Seven joints also underwent a rthroscopy, which showed intra-articular disease that was consistent with t he original trauma. Five patients had reflex sympathetic dystrophy, three o f which resolved after nerve release. Nerve conduction studies were not hel pful. Careful physical examination and local nerve blocks were most importa nt in making the diagnosis and prescribing treatment. All conservative meas ures should be exhausted before surgery is considered.