Common Peroneal Nerve Palsy

Symptoms include:

• Pain, weakness or numbness in the top of the foot or shin
• Inability to move the foot in all directions
• Difficulty pointing the toes upward

Causes include:

• Direct trauma may injure the nerve
• Scarring after trauma can cause compression of the nerve
• The nerve can be compressed by a tumour or cyst
• Hip/knee replacement surgery can directly injure the nerve or cause scarring that can compress the nerve
• Knee dislocation/fracture can cause nerve injury

A discussion of your medical history and a physical examination are the first steps. To assess the extent of nerve compression, Dr Shiva may recommend the following:

• Electromyography to measure muscle activity, and response to stimulation
• Nerve conduction study to assess the speed and quantity of conduction of an electrical impulse through the affected nerve
• MRI to assess the anatomy of the nerve and surrounding tissues

Treatment is based on the degree of impairment and the location where the damage has occurred. For milder cases, nonsurgical treatments may include:

• Brace
• Custom insoles for shoes (orthotics)
• Physical therapy
• Rest

If the dysfunction is moderate to severe, surgery may be required.

Nerve decompression of the common peroneal nerve is performed under general anaesthesia. During the procedure, an incision is made along the outer side of the knee, providing access to the site of entrapment or compression that is then released.

Postoperative care

• Keep the wound dry for five days. Then dressings can be removed
• Monitor for any wound redness, discharge, fevers
• Six-week review with Dr Shiva