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Sensory nerve damage during surgery on the hallux
1Department of Orthopaedic Surgery, Bridge of Earn Hospital, Perthshire, UK.
Journal of the Royal College of Surgeons of Edinburgh
|December 1, 1992
Summary
Surgical division of the superficial peroneal nerve during hallux surgery frequently causes nerve damage and neuroma. A simple surgical technique can help avoid this common complication, improving patient outcomes.
Area of Science:
- Orthopedic Surgery
- Neuroanatomy
- Podiatric Medicine
Background:
- Division of the medial branch of the superficial peroneal nerve during hallux surgery can result in neuroma formation and other symptoms.
- The incidence and awareness of such nerve damage are not well-documented.
Purpose of the Study:
- To determine the incidence and consequences of superficial peroneal nerve damage during hallux surgery.
- To present a simple surgical solution to prevent nerve damage.
Main Methods:
- Clinical examination and patient questioning of 75 feet (51 patients) with a mean 4-year follow-up.
- Cadaveric dissection of 10 feet to identify reliable surface markings for nerve avoidance.
Main Results:
- Clinical evidence of nerve damage was found in 45% of cases.
- Only 29% of patients were aware of their symptoms preoperatively.
- Severe, disabling symptoms occurred in 3% of patients.
- Cadaveric dissections provided a reliable surface marking for surgical navigation.
Conclusions:
- Damage to the superficial peroneal nerve during hallux surgery is common, with many patients unaware of their symptoms.
- A simple, easily applied surgical technique can mitigate the risk of nerve injury.