Decompression of the common peroneal nerve: Experience with 20 consecutivecases

A retrospective review of 20 patients with common peroneal nerve palsy trea ted with decompression between 1986 and 1997 was undertaken. Subjects were evaluated preoperatively and postoperatively by electromyography, nerve con duction, and clinical measures. The mean interval between the onset of symp toms to surgery (operative delay) was 15.9 months. The mean postoperative e follow-up was 32.2 months with a minimum follow-up of year. Decompression was performed at the level of the fibular neck and slightly distally at til e tendinous origin of the peroneus longus using a standard approach to rele ase tight fascial structures or scar tissue. External neurolysis was perfor med using the operating microscope in two cases for which scarring of the n erve was identified intraoperatively. Postoperatively, ly of 20 patients sh owed improvement in ankle dorsiflexion as assessed by the Medical Research Council scale. Electromyographic examination was useful in the preoperative evaluation and selection of patients for decompression surgery. In conclus ion, decompression even after a 1-year delay may offer benefit and suggest early intervention in patients with a severe lesion.