Traumatic Peroneal Nerve Injuries: A Systematic Review.

Area of Science:

• Orthopedics
• Neurology
• Regenerative Medicine

Background:

• The common peroneal nerve (CPN) is the most frequently injured lower extremity peripheral nerve due to trauma.
• Traumatic CPN injuries historically yield suboptimal outcomes and patient satisfaction.
• Advances in surgical techniques offer potential for improved CPN injury management.

Purpose of the Study:

• To systematically review and summarize current literature on traumatic CPN injuries.
• To analyze treatment options, outcomes, and prognostic variables for CPN injuries.
• To provide evidence-based recommendations for CPN injury treatment and future research.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted.
• Searches were performed across PubMed, Embase, and Cochrane databases.
• Data on treatment, outcomes, and demographics were extracted and analyzed.

Main Results:

• 42 studies met eligibility criteria from over 2,300 initial articles.
• Positive prognostic factors include shorter preoperative intervals, nerve continuity, and younger patient age.
• Successful outcomes (MRC grade ≥M3) varied by procedure: neurolysis (81.4%), end-to-end suturing (78.8%), nerve transfer (62.9%), nerve grafting (49.0%), PTTT (81.5%), and concurrent PTTT (84.2%).

Conclusions:

• Heterogeneity in studies complicates definitive treatment recommendations for CPN injuries.
• No single treatment is universally superior due to diverse injury types and patient factors.
• Future research should stratify outcomes by injury modality and surgical approach, exploring novel techniques.