Concept

Peroneal nerve paralysis

Summary
Peroneal nerve paralysis is a paralysis on common fibular nerve that affects patient’s ability to lift the foot at the ankle. The condition was named after Friedrich Albert von Zenker. Peroneal nerve paralysis usually leads to neuromuscular disorder, peroneal nerve injury, or foot drop which can be symptoms of more serious disorders such as nerve compression. The origin of peroneal nerve palsy has been reported to be associated with musculoskeletal injury or isolated nerve traction and compression. Also it has been reported to be mass lesions and metabolic syndromes. Peroneal nerve is most commonly interrupted at the knee and possibly at the joint of hip and ankle. Most studies reported that about 30% of peroneal nerve palsy is followed from knee dislocations. Peroneal nerve injury occurs when the knee is exposed to various stress. It occurs when the posterolateral corner structure of knee is injured. Relatively tethered location around fibular head, tenuous vascular supply and epineural connective tissues are possible factors that cause damage on the common peroneal nerve. Treatment options for nerve palsy include both operative and non-operative techniques. Initial treatment includes physical therapy and ankle-foot orthosis. Physical therapy mainly focuses on preventing deformation by stretching the posterior ankle capsule. A special brace or splint worn inside the shoe (called an Ankle Foot Orthosis) holds the foot in the best position for walking. Orthosis stretches posterior ankle structures. Physical therapy can help patients to learn how to walk with a foot drop. Signs and symptoms of peroneal nerve palsy are related to mostly lower legs and foot which are the following: Decreased sensation, numbness, or tingling in the top of the foot or the outer part of the upper or lower leg Foot drops (unable to hold the foot straight across) Toes drag while walking Weakness of the ankles or feet Prickling sensation Pain in shin Pins and needles sensation Slapping gait (walking pattern in which each step makes a slapping noise) Patients may need pain relievers to control pain.
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