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Identifying Common Peroneal Neuropathy before Foot Drop.

Abstract：

BACKGROUND:Common peroneal neuropathy shares the same pathophysiology as carpal tunnel syndrome. However, management is often delayed because of the traditional misconception of recognizing foot drop as the defining symptom for diagnosis. The authors believe recognizing common peroneal neuropathy before foot drop can relieve pain and help improve quality of life. METHODS:One hundred eighty-five patients who underwent surgical common peroneal neuropathy decompression between 2011 and 2017 were included. The mean follow-up time was 249 ± 28 days. Patients were classified into two stages of severity based on clinical presentation: pre-foot drop and overt foot drop. Demographics, presenting symptoms, clinical signs, electrodiagnostic studies and response to surgery were compared between these two groups. Multivariate regression analysis was used to identify variables that predicted outcome following surgery. RESULTS:Overt foot drop patients presented with significantly lower preoperative motor function (percentage of patients with Medical Research Council grade ≤ 1: overt foot drop, 90 percent; pre-foot drop, 0 percent; p < 0.001). Pre-foot drop patients presented with a significantly higher preoperative pain visual analogue scale score (pre-foot drop, 6.2 ± 0.2; overt foot drop, 4.6 ± 0.3; p < 0.001) and normal electrodiagnostic studies (pre-foot drop, 31.4 percent; overt foot drop, 0.1 percent). Postoperatively, both groups of patients showed significant improvement in quality-of-life score (pre-foot drop, 2.6 ± 0.3; overt foot drop, 2.7 ± 0.3). Patients with obesity or a traumatic cause for common peroneal neuropathy were less likely to have improvements in quality of life after surgical decompression. CONCLUSION:Increased recognition of common peroneal neuropathy can aid early management, relieve pain, and improve quality of life. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, II.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Lu JC,Dengler J,Poppler LH,Van Handel A,Linkugel A,Jacobson L,Mackinnon SE

doi

10.1097/PRS.0000000000007096

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

664-675

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-202009000-00035

journal_volume

146

pub_type

杂志文章

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Identifying Common Peroneal Neuropathy before Foot Drop.