Peroneal nerve entrapment (Fibular tunnel syndrome)

The peroneal nerve is mostly compressed at the lateral side of the knee between the leg bone called the fibula and the muscles and ligaments. It is characterized by weakness of the muscles that lift the foot up from the ankle. The patient has to drag his ankle because he cannot keep it straight while walking. There is also numbness on the feet. For this reason, it can sometimes be confused with nerve root compression due to herniated disc.

 

The causes of peroneal nerve entrapment are internal (fibula and distal femur fractures, dislocations of the knee joint, excessive stretching of the knee due to trauma, nerve damage during surgical procedures, tumors such as peroneal vessel aneurysms, osteochondroma and synovial cysts) and external (tight elastic dressing, dressing, bandage, etc.). plaster jacket, fiberglass splints, knee stabilizers, leg orthoses, tourniquets and ice packs).

 

In acute events, more motor involvement than sensory is in the foreground. In more chronic events such as cysts and tumors, there is pain and slowly progressive motor and sensory disturbances.

 

Electrodiagnostic (EMG) evaluation is necessary for diagnosis and prognosis. The entrapment is seen in patients under coma or general anesthesia both positionally as well as occupationally in kneeling and bending. The reason for entrapment following excessive weight loss is the sensitivity of the nerve to trauma at the head of the fibula.

 

In cases that do not improve with physical therapy, surgery is required. The operation is in the form of releasing the nerve at the entrapment area with local or general anesthesia.