Traumatic injuries of the tibial nerve: etiopathogenesis and surgical outcome

Background. Injuries of the tibial nerve are a rather rare neuropathy of the peripheral nervous system. The tibial nerve may be injured at any point from the distal thigh to the foot. The most common causes of lesions include bone fractures, knee and ankle dislocations, wounds, compartment syndrome, and iatrogenic injuries. Material and methods. We studied 39 patients with tibial nerve injuries, analyzing the causes of lesion and the mechanism of injury. The outcome of surgical treatment was evaluated in 25 cases. We evaluated the muscle strength based on the BMRC scale (M0- M5) and sensory recovery based on the modified Highet scale (S0 - S4). The following outcome categories were applied: very good - M4-5, S3-4; good - M3-4-5, S2; unsatisfactory - M2, S1; poor - M0-1, S0. Results. After surgical treatment we obtained 7 very good and 10 good results. Unsatisfactory recovery was observed in 4 cases and poor outcome in another 4 cases. Conclusions. The outcome of surgical treatment is dependent on early operative intervention, and on the mechanism, degree and level of injury of the tibial nerve.