Early Surgical Treatment for Severe Idiopathic Compression of the Common Peroneal Nerve: A Case Series
Abstract
Introduction: Compression of the common peroneal nerve (CPN) is a common condition in the lower limb and can be either idiopathic or secondary. While secondary compressions have been extensively studied and show good outcomes with microsurgical decompression, evidence regarding idiopathic compressions remains limited. This study aims to report cases of severe idiopathic CPN compression treated surgically, evaluate clinical outcomes, and assess the need for a standardized treatment protocol. Materials and Methods: A retrospective review was conducted on patients diagnosed with idiopathic CPN palsy over the past 10 years. Inclusion criteria comprised cases with a positive electromyogram, no history of trauma, negative MRI findings, and normal intraoperative findings. Patients with secondary nerve entrapment, spinal pathology, psychiatric disorders, or pregnancy were excluded. Severe cases were defined as those presenting with a dorsiflexion motor deficit of ≤2/5. Preoperative, intraoperative, and postoperative variables were analyzed. Results: Eight patients met the inclusion criteria (2 women, 6 men). The mean time from diagnosis to surgery was 30 days, with an average follow-up of 959 days. All patients regained at least 4/5 dorsiflexion strength. Six patients achieved full recovery of both strength and sensation. No complications were reported. Conclusions: Early decompression of the CPN is a safe and effective procedure for severe idiopathic compression. The establishment of a standardized treatment protocol is recommended.Downloads
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