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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2000 April;51(2):49-54
Surgical treatment of traumatic peroneal nerve lesions: 64 cases
Megaro A., De Filippo G., Fenu R., Tassi M., Pazzaglia U. E.
Background. Most authors report surgical exploration of post-traumatic peroneal nerve palsy, if spontaneous regeneration does not occur in 4-6 months. Recent studies have reported surgical results more encouraging than in the past, and similar to the other nerve lesions repair. The experience of the Orthopaedic Department of the University of Brescia is reported.
Methods. This study reports the results of 64 peroneal nerve lesions, treated at Orthopaedic Department of the University of Brescia, with different surgical tecniques: 31 neurolysis, 20 grafts (median size 5 cm), 9 direct neurotizations, 4 end-to-end sutures.
Results. Forty-four of these patients (68.75%), at a median follow-up of 5 years, had satisfactory results, with return to walk without steppage. Recover occurs in approx. 14.5 months after surgical treatment.
Conclusions. Evaluation of injury mechanism and surgical exploration, with intraoperative nerve action potential, determines surgical choice treatment. Surgical repair must be done not over 3.5 months after injury. Patients included in this study who waited more than 4 months after lesion for treatment, had a 30%, instead of 70%, of satisfactory results. Time of recovery after operation is unforeseeable, and sometimes it takes a lot of time.