Surgical treatment for peroneal nerve palsy.

Y H Chaing, M C Chang, Y Liu, W H Lo
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Abstract

Background: Peroneal nerve palsy is the most frequently encountered mononeuropathy of the lower extremities. Although many studies advocated spontaneous resolution of peroneal nerve palsy, more recent studies confirmed obvious improvement with surgical treatment techniques.

Methods: This study reviewed the results obtained from surgically treated peroneal nerve palsy in 14 patients who were admitted to our hospital between 1990 and 1996. The patients consisted of 12 males and two females with an average age of 31 years (range, 12-68 years). Peroneal nerve palsy in these patients was caused by direct or indirect injury, as confirmed by clinical examination and electromyography. The status of the nerve was observed for at least 4 months and explored when the nerve failed to reveal evidence of recovery. The nerve was decompressed, repaired or reconstructed by nerve grafting, according to the status of the injury. Weber scales were used to assess the peripheral neuropathies preoperatively and postoperatively.

Results: At a mean of 23 months (range, 11-61 months), nerve palsy scores improved from an average of 5 points to 3.14 points. Despite the small number of patients, our results indicated that the time interval between onset of injury and date of surgical treatment (p < 0.05) was the most significant factor to influence the prognosis of surgery. Results obtained from surgery were not related to the method of treatment, length of nerve graft or mechanism of injury.

Conclusions: Because peroneal nerve palsy does not always resolve spontaneously, this study favored early surgical exploration for peroneal nerve dysfunction, based on at least 4 months of follow-up.

腓神经麻痹的外科治疗。
背景:腓神经麻痹是最常见的下肢单神经病变。虽然许多研究主张腓神经麻痹的自然消退,但最近的研究证实手术治疗技术有明显改善。方法:回顾1990 ~ 1996年收治的14例腓神经麻痹患者的手术治疗结果。患者男性12例,女性2例,平均年龄31岁(范围12 ~ 68岁)。经临床检查和肌电图证实,腓骨神经麻痹是由直接或间接损伤引起的。观察神经状态至少4个月,并在神经未显示恢复迹象时进行探查。根据损伤情况对神经进行减压、修复或植神经重建。术前和术后采用Weber量表评估周围神经病变。结果:平均23个月(范围11-61个月),神经麻痹评分由平均5分提高到3.14分。尽管患者数量较少,但我们的结果表明,损伤发生时间与手术治疗日期之间的时间间隔(p < 0.05)是影响手术预后的最显著因素。手术结果与治疗方法、神经移植长度及损伤机制无关。结论:由于腓神经麻痹并不总是自发解决,本研究倾向于腓神经功能障碍的早期手术探查,基于至少4个月的随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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