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Common peroneal nerve dysfunction after high tibial osteotomy.

P Curley1, K Eyres, V Brezinova

  • 1Medical Physics Department Leicester Royal Infirmary, England.

The Journal of Bone and Joint Surgery. British Volume
|May 1, 1990
PubMed
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High tibial osteotomy can cause nerve issues. Proximal fibular osteotomy is linked to common peroneal nerve palsy, indicating a need for further research into nerve blood supply.

Area of Science:

  • Orthopedic Surgery
  • Neurophysiology
  • Biomedical Engineering

Background:

  • High tibial osteotomy (HTO) is a common surgical procedure for knee osteoarthritis.
  • Postoperative complications, including nerve palsy, can occur following HTO.
  • The common peroneal nerve is particularly vulnerable due to its anatomical location.

Purpose of the Study:

  • To investigate electrophysiological changes and risk factors for common peroneal nerve palsy after high tibial osteotomy.
  • To determine if preoperative factors predict postoperative nerve complications.
  • To assess the impact of proximal fibular osteotomy on nerve function.

Main Methods:

  • Electrophysiological recordings were performed on 16 patients before and after HTO.
  • Creatine phosphokinase levels, radiographs, and intracompartmental pressure were monitored.

Related Experiment Videos

  • Patients were evaluated for the development of common peroneal nerve palsy.

    • Main Results:

    • Mild electrophysiological abnormalities were present preoperatively in 12/16 patients.
    • Postoperative electrophysiological abnormalities worsened in 11/14 patients.
    • Proximal fibular osteotomy was associated with increased electrical abnormalities and two cases of common peroneal nerve palsy.

    Conclusions:

    • Proximal fibular osteotomy is a potential causative factor for common peroneal nerve palsy after HTO.
    • Preoperative creatine phosphokinase, compartment pressure, and deformity did not predict palsy.
    • Further investigation into the nerve's blood supply is warranted.