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Transient peroneal nerve palsies from injuries placed in traction splints
W M Mihalko1, B Rohrbacher, B McGrath
1Department of Orthopaedic Surgery, State University of New York at Buffalo, USA.
The American Journal of Emergency Medicine
|April 2, 1999
Summary
Traction splints can cause peroneal nerve palsies in patients with knee ligament injuries, even without fractures. Prompt removal of the splint typically resolves nerve function loss.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Neurology
Background:
- Distal femur fractures are common trauma presentations.
- Traction splints are frequently used for lower extremity immobilization.
- Peroneal nerve palsy can result from various injuries and external devices.
Observation:
- Two patients presenting with suspected distal femur fractures and traction splints developed peroneal nerve palsies.
- Neither patient had a fracture; both had lateral collateral ligament injuries, one with an anterior cruciate ligament tear.
- Nerve function was restored within 6 hours after traction splint removal.
Findings:
- Traction splint application in knee ligament injuries, particularly lateral collateral ligament injuries, can lead to peroneal nerve compromise.
- The nerve deficit was transient and resolved upon splint removal, suggesting external compression or positional injury.
- Absence of fracture does not preclude complications from immobilization devices.
Implications:
- Clinicians must consider traction splint-induced peroneal nerve injury in patients with knee soft tissue injuries.
- Proper indication and application of traction splints are crucial to avoid iatrogenic complications.
- Early recognition and removal of the offending splint can prevent prolonged nerve dysfunction.