American Society for Peripheral Nerve

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Functional Outcome in Common Peroneal Nerve (CPN) Injury Using Neurolysis/ Primarily Nerve Repair / Nerve Graft, a Comprehensive Single Center 28 Years’ Experience
Arash Izadpanah, MD, FRCSC1; Ahmet H. Sakarya, MD2; Bassem W Daniel, MD3; David Chwei-Chin Chuang, MD4
1Chang Gung Memorial Hospital, Taoyuan City, Taiwan, 2Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan, 3Chang Gung Memorial Hospital, taoyuan City, Taiwan, 4Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Taiwan

Background: Foot drop is a devastating deformity in patient with common peroneal nerve (CPN) injury. The standard surgical treatments are categorized into three main categories, nerve related operations, tendon transfers and free functioning muscle transplantation. The results of Nerve operations (neurolysis, nerve repair or graft) remain controversial. We presented our experience in CPN injury, employing neurolysis, nerve repair, and nerve graft in a single institution.

Methods: Between 1988 and 2016 (28-year period) 38 patients with CPN injury received either neurolysis, primarily nerve repair, or nerve graft. The hospital records were reviewed retrospectively and independently by two authors, and patients were called for a final assessment including range of motion (ROM), passive and active, and muscle strength powers of ankle and toes.

Results: In this cohort, 27 (71%) of all patients, irrespective of type of nerve operation, obtain good to excellent outcomes at their time of their last examination. 100% of patients with neurolysis or primary nerve repair achieved excellent outcomes. 73.4% of patients requiring nerve grafts shorter than 6 cm for CPN injury had good to excellent results compared to 25% in those with grafts longer than 6 cm.

Conclusion: CPN injury surgery is often associated with underwhelming surgical outcomes in printed literature, especially those undergoing nerve related operations. However, with appropriate patient selection and meticulous surgical techniques one could expect good to excellent functional outcomes in such patient population.

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