The peroneal nerve: is repair worthwhile?

In this study, the long-term results of secondary common peroneal nerve repair are evaluated. The general consensus has been that the long-term outcome of peroneal nerve repair is poor, because of its mixed sensory-motor nature and the long-distance necessary for axon regeneration. Since the introduction of microneurosurgery and autogenous nerve grafting, an amelioration of poor results might be expected; however, recent reports on common peroneal nerve repair are not available. Four patients underwent either direct peroneal nerve repair (2) or nerve grafting (2) over a five-year period. Dorsiflexion was achieved with peroneal muscle power Grade 3 or above in three patients. The fourth patient is still regaining peroneal power and has not plateaued. These results show that secondary common peroneal nerve repair, even with autogenous nerve grafting, is a worthwhile procedure. The age of the patient, the timing of the repair, meticulous microsurgical technique, and avoidance of tension are critical factors in achieving a successful outcome.