[Peroneal nerve paresis after long-term bed rest in intensive care patients]

Despite careful nursing and physiotherapy, wasting, myopathy and neuropathy are commonly seen in sedated or comatose intensive care patients undergoing long term bedrest. Four cases of peroneal nerve lesion with drop-foot are described in patients with up to eight weeks of immobilisation due to severe infections complicated with multiple organ failure. No other peripheral nerve compression syndromes were found. These isolated nerve lesions could not be related to the metabolic or cerebral status of the patients. To avoid rotation of the hipjoints with secondary muscle contracture the nursing procedure in the ICU had been changed shortly before the incidents of drop-foot were detected. Along with well-known prophylactic anti-compression procedures, sandbags were now placed on the lateral side of the knees. After abandoning this new procedure, peroneal nerve lesions have not been seen.