Ultrasound-guided Hydrodissection and Integrated Rehabilitation for Postsurgical Common Peroneal Nerve Entrapment

Area of Science:

• Neurology
• Orthopedics
• Regenerative Medicine

Background:

• Postoperative common peroneal nerve (CPN) entrapment frequently causes iatrogenic foot drop.
• A standardized rehabilitation protocol for this condition is currently lacking.
• This study addresses the need for an effective management strategy.

Purpose of the Study:

• To present a step-by-step visual demonstration of an integrated protocol for managing postoperative CPN entrapment.
• To combine ultrasound-guided hydrodissection with structured task-oriented rehabilitation.
• To offer a replicable framework for treating refractory cases.

Main Methods:

• Real-time ultrasound identification of CPN entrapment.
• In-plane, multi-quadrant hydrodissection using a dextrose, lidocaine, and mecobalamin injectate.
• Phased rehabilitation program including neural gliding, therapeutic ultrasound, neuromuscular electrical stimulation, and task-oriented training.

Main Results:

• Significant improvement in leg-foot angle during dorsiflexion (38° reduction).
• Restoration of normal gait parameters: heel-strike, push-off, and swing-phase foot clearance.
• Electromyography (EMG) confirmed reinnervation potentials in key leg muscles.

Conclusions:

• The combined approach of percutaneous nerve decompression and task-specific rehabilitation is feasible.
• This protocol offers a reproducible method for managing postoperative CPN entrapment.
• The study provides a promising framework for improving functional outcomes in patients with foot drop.