Superficial Peroneal Nerve Injured During Fasciotomy: A Successful Repair with Cadaveric Nerve Allograft
Joseph Ogrodnik, MD; Michael T. Friel, MD, FAAP
University of Mississippi Medical Center, Jackson, MS
Introduction: Injury to the superficial peroneal nerve is a known complication of a lower extremity fasciotomy.A recent publication from a Level 1 academic center reported an incidence of 7%.There is no consensus for management of such an injury.A review of literature found no published reports of successful nerve repair after lower extremity fasciotomy injury. We present a case of a 10 year old male who was involved in an all-terrain-vehicle (ATV) accident.He sustained a femur fracture and injury to his superficial femoral artery.A femoral to popliteal bypass was performed with saphenous vein graft.After reperfusion was established, a four compartment, two incision lower extremity fasciotomy was performed.The superficial peroneal nerve was injured during the fasciotomy with subsequent loss of sensation to lateral leg and dorsum of foot.
Materials and Methods: This is a case presentation of a repair of a superficial peroneal nerve injury.The nerve was repaired using a cadaveric allograft for a 13 mm gap.We will highlight details of the repair and clinical course of the patient.A review of published literature on the topic will be discussed.
Results: Clinical exam 12 weeks after repair demonstrated near complete return of sensation in the distribution of the superficial peroneal nerve.We have demonstrated that a successful repair can be performed on this type of injury.
Conclusions: The lateral incision for a lower extremity fasciotomy puts the superficial peroneal nerve at risk. Proper technique and knowledge of anatomy can prevent injury.However, if an injury has occurred, repair of the nerve should be attempted.The use of cadaveric allograft nerve repair has been well-documented in upper extremity nerve injuries, and should be considered for use in lower-extremity nerve injuries.
Back to 2017 ePoster Listing