Superficial peroneal nerve entrapment. A case report.

I. M. R. Lowdon, MA, MB DhB, FRCS Ed, FRCS, Senior Registrar in Orthopaedic and Traumatic Surgery John Radcliffe Hospital, Headington, Oxford OX39DU, England. C 1985 British Editorial Society of Bone and Joint Surgery 0301-620X/85/ 1007 $2.00 _____________ dorsum of the foot. There was no history of trauma, but walking exacerbated his symptoms and the pain occasionally radiated into his thigh. He walked with a limp. He had an exquisitely tender spot 10 cm above the lateral malleolus; percussion over this area caused pain to shoot down the leg onto the dorsum of the foot. Pressure over the common peroneal nerve at the fibular neck caused local pain, but with no radiation down the leg nor sensory symptoms. There was no muscle weakness, nor any definite sensory abnormality. The patient’s back, hip, knee and ankle were clinically normal; radiographs of the tibia and fibula also were normal. There was no suggestion of nerve root compression, and electrophysiological testing demonstrated no abnormality of the common peroneal nerve, nor of the proximal nerve roots. The site of maximal tenderness above the lateral malleolus was explored: the cutaneous terminal branch of the superficial peroneal nerve was found to run an oblique course of over 1 cm through the deep fascia; the nerve, which was adherent to the fascia, was dissected free (Fig. I). The fascia was then split for a few centimetres above and below the point where the nerve emerged. This procedure completely relieved the patient’s symptoms.