Unusual entrapment of deep peroneal nerve after femoral distal extension osteotomy

The lateral exposure of the supracondylar femur includes the risk of damaging the neurovascular structures or tightening of the neurological structures within the popliteal fossa may occur as a complication of the osteotomy. Although different pathways of common peroneal nerve (CPN) have been reported throughout the literature, division of deep and superficial branches above the supracondylar femur level has not been reported. A 15-year-old boy with bilateral knee flexion contracture and spastic diplegic cerebral palsy underwent bilateral femoral distal extension osteotomy. The authors found an unusual higher division of CPN above the supracondylar femur level. This report is aimed at warning surgeons about the division of the CPN at a higher level and highlighting a need for a high-powered cadaveric research.