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Related Experiment Video

Updated: Jul 7, 2026

The Muscle Cuff Regenerative Peripheral Nerve Interface for the Amplification of Intact Peripheral Nerve Signals

The Muscle Cuff Regenerative Peripheral Nerve Interface for the Amplification of Intact Peripheral Nerve Signals

Published on: January 13, 2022

Peroneal nerve compression by lateral gastrocnemius flap.

James R Sanger¹, Dennis S Kao, Donald A Hackbarth

¹Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jsanger@mcw.edu

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|January 29, 2008

Summary

Lateral gastrocnemius flaps can cause peroneal neuropathy due to nerve compression by the flap. Surgical intervention involving fascial excision and motor denervation improved patient outcomes, suggesting preventative measures.

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The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits

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Area of Science:

Plastic Surgery
Neurology

Background:

Lateral gastrocnemius muscle flaps are a standard reconstructive technique for lower limb defects.
Peroneal neuropathy is a known complication, typically linked to direct intraoperative nerve injury.

Observation:

A case study identified a novel cause of peroneal neuropathy: compression by the gastrocnemius flap itself.
A 56-year-old female developed common peroneal nerve palsy 10 months post-flap surgery.
Exploration revealed a neuroma formed under a fascial band of the rotated gastrocnemius muscle.

Findings:

The gastrocnemius muscle's motor nerve was intact, but flap contraction caused nerve compression.
Surgical treatment included excision of the lateral fascia and selective motor denervation.
The patient experienced symptom improvement after the intervention.

Implications:

This case highlights flap-induced compression as a cause of peroneal neuropathy.
Recommends fascial excision and selective motor denervation to prevent this complication in future gastrocnemius flap surgeries.