Double Axonal Crush, Transection, and Implantation of Deep Peroneal Nerve for Intractable Pain

Abstract

Introduction: Intractable pain following calcaneal fracture is a rare, but debilitating complication for a patient. The aim of this study was to assess if a double axonal crush with deep peroneal nerve (DPN) implantation is effective in alleviating residual intractable pain following surgical repair of Sanders III and IV calcaneal fractures. Methods: Eleven patients underwent DPN resection, double axonal crush, and bone implantation for entrapment of the distal portion of the DPN confirmed via EMG with a mean follow-up period of 26 months. The Visual Analog Scale and Quality of Life were used as scoring systems. Results: Results show a statistically significant (p Discussion: DPN resection, double axonal crush, and implantation into the tibia offers promising results, and further studies may be warranted to confirm as a valid treatment option.