Dynamic Common Peroneal Nerve Compression Diagnosed With the Orthogonal Kinesiotaping Test: A Prospective Clinical...

Dynamic compression of the common peroneal nerve (CPN) at the knee remains underdiagnosed because static investigations, including electromyography and magnetic resonance imaging, may fail to detect positional nerve entrapment. The orthogonal kinesiotaping test (OKT), adapted from the Lacertus Antagonist Test for dynamic median nerve compression, uses kinesiotape applied perpendicular to the nerve to provide temporary decompression. This prospective monocentric study evaluates OKT for diagnosing dynamic CPN compression. Patients meeting the Hagert triad-tenderness over the fibular tunnel, selective dorsiflexion or eversion weakness varying with limb position, and a positive Scratch Collapse Test-were included. Ultrasound or magnetic resonance imaging excluded extrinsic causes. A 5-cm kinesiotape strip was applied perpendicular to the CPN at the fibular neck with approximately 20% tension. A positive test required improvement of at least 1 Medical Research Council grade, patient-reported functional improvement, and examiner-confirmed increased resistance. OKT was performed on 124 knees in 111 patients, including 55 men, 56 women, and 13 bilateral cases. Immediate strength improvement occurred in all patients except 4 with complete paralysis. Pain decreased in all patients, and fatigability improved in 96.4% of patients. Benefits disappeared after tape removal. OKT is a simple, reproducible, noninvasive test demonstrating immediate, reversible functional improvement consistent with dynamic mechanical compression. It may constitute a fourth clinical sign within the Hagert diagnostic framework and could be applicable to other dynamic nerve entrapments.