Peroneal nerve neuropathy
Peroneal nerve neuropathy is a rare disease that occurs in girls aged 10 to 19 years. Peroneal nerve neuropathies have a poor prognosis. The peroneal nerve is located on the lateral surface of the lower leg, passes along the head of the fibula, is divided into a superficial and deep branch. The deep branch is pressed by the dense edge of the muscle tendons and can be damaged by the bony protrusion of the fibular head.
Peroneal nerve neuropathy occurs due to the peculiarities of the anatomical structure. The injury is facilitated by an injury of the knee joint or ligamentous apparatus, fractures of the lower leg bones. Often after knee surgery, compression of the nerve trunk by the head of the fibula may occur. Neuropathy causes some changes in physical condition, disrupts motor functions.
For example, with such a pathology, patients can spontaneously twist the foot when walking or running, their dorsiflexion is impaired and the ability to rotate the foot is lost, the ability to extend the fingers worsens. The peroneal nerve innervates the extensor muscles of the foot, the extensors of the toes, and the muscles responsible for turning the foot from the outside, and is also responsible for sensitivity.
The disease begins with a sagging foot, the so-called "cock gait" develops, shoes without a backdrop fall off when moving, limitation of passive movements of the foot and ankle joint is noted, walking on heels becomes impossible. With damage to the peroneal nerve, a decrease in the muscles on the anterior, outer part of the lower leg is noticeable.
In medical diagnostics, paresis or paralysis of the anterior tibial muscle, peroneal longus, extensor longus of the fingers, long extensor of the thumb, short peroneal muscle may be found. All this violates the extension of the foot and toes, rotation and abduction of the foot, extension of the big toe.
After a while, sensitivity in the back of the foot is disturbed. In case of untimely referral to a specialist, deformity of the lower limb and the head of the fibula may develop.
Ways to eliminate the disease
In the diagnosis, the MRI method is used to determine the presence of compression of the peroneal nerve at the entrance to the canal.
Treatment of neuropathy of the peroneal nerve in the initial stages, when there is a partial violation of conduction, includes electrical stimulation of the affected muscles, massage and thermal procedures, and the use of agents that normalize microcirculation processes.
Indications for surgical treatment are complete conduction disturbances, ineffectiveness of conservative treatment, and relapse. Surgical treatment of the nerve trunk is a decompression of the nerve and plastic of the canal walls. With chronic lesions of the nerve, the absence of muscle innervation, operations are performed to move the tendons.
The postoperative period is associated with long-term rehabilitation. In non-started stages, a quick recovery is possible when using exercise therapy. Physical exercise, which is effective treatment, is divided into those that improve the blood supply to the nerves of the legs and those that help restore muscle function. Exercise, by increasing the blood supply to the affected nerves, eliminates the inflammatory process.
The peroneal nerve is very "vulnerable", therefore, in the process of treatment, they resort to the help of traumatologists, rheumatologists, because often neuropathic pathology can be the result of any systemic disease. If the necessary remedies are not used in a timely manner, this leads to irreversible dysfunctions of the nerve.
Nerve damage does not always occur at the time of injury, but also during the period of subsequent treatment due to a long attempt to restore the function of the limb. The lesion continues as a result of compression of the nerve by tissue edema or bone fragments. And therefore, it is difficult to achieve normalization of the nerve, often it is necessary to use tendon-muscle plastics to fix the foot. Modern medicine has not yet fully studied issues related to the neuropathy of the peroneal nerve. Today, the features of various variants of peroneal nerve syndrome and the levels of fiber damage are being studied.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".