Common peroneal nerve decompression

Common peroneal neuropathy occurs as a result of compression of the common peroneal nerve (CPN) in the fibro-osseous tunnel between the fibular neck and the tendinous arch of peroneus longus. High rates of spontaneous recovery have been reported. However, there is a subset of patients who require decompression of the CPN at the fibular neck.

We performed a retrospective analysis of patients that underwent decompressive surgery of the CPN. A total of 22 operations performed on 20 patients were analysed. Pre-operative workup included clinical examination, electrophysiological testing and magnetic resonance imaging (MRI) where indicated. Post-operatively, all patients were examined clinically for neurological recovery and where indicated, electrophysiology was repeated.

74% of patients (14 out of 19) with motor weakness improved, as did 68% with sensory dysfunction. 69% with foot drop improved to have no foot drop, most of these were those that underwent surgery within 12 months of symptom onset (OR 14.7, 95% CI 1.4–133.5).

Patients with foot drop fared significantly better if their duration of symptoms prior to surgery was less than 12 months.