Current Concepts Review: Common Peroneal Nerve Palsy After Knee Dislocations

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Sports Medicine

Background:

• Knee dislocation is a complex injury with a high incidence of associated common peroneal nerve (CPN) damage.
• Prompt neurovascular assessment is critical due to the risk of popliteal artery injury and limb ischemia.
• Management necessitates a multidisciplinary approach involving orthopedic, peripheral nerve, and foot and ankle surgeons.

Purpose of the Study:

• To outline the comprehensive management strategy for knee dislocations with concurrent common peroneal nerve palsy.
• To emphasize the importance of interdisciplinary collaboration in optimizing patient outcomes.
• To highlight surgical techniques for peroneal nerve repair and restoration of foot dorsiflexion.

Main Methods:

• Review of current literature and clinical practice guidelines for knee dislocation and CPN injury.
• Description of the coordinated surgical pathway involving ligamentous reconstruction, nerve decompression/reconstruction, and tendon transfer.
• Specific mention of the Bridle Procedure as a reconstructive option for foot drop.

Main Results:

• Successful outcomes, including brace-free ambulation and return to athletic function, are achievable with appropriate surgical intervention.
• Timely operative management and preservation of passive dorsiflexion are crucial for tendon transfer success.
• Multidisciplinary care ensures optimal timing and execution of staged or concurrent procedures.

Conclusions:

• Effective management of knee dislocation with CPN palsy relies on seamless collaboration between surgical specialties.
• Surgical reconstruction, including nerve repair and tendon transfer, can restore significant function and improve quality of life.
• A coordinated approach maximizes the potential for successful recovery and return to pre-injury activity levels.