Treatment of traction combined injury of peroneal nerve

Sergey Strafun, Vasyl Gayovich, Oksana Gayko, Oleksandr Strafun


Recovery of the movement function of foot after the injury of peroneal nerve (PN) did not happen in 47.6 %. This is an indication for surgical treatment. Traction injuries of PN combined with the injuries of knee joint (KJ) ligaments are even more challenging to treat. Goal: to work out an algorithm to treat these patients and give practical recommendations on the ground of analysis of clinical data. Methods: the results of treatment of 35 patients (average age 31.8 ± 11.9 years) with the injury of PN and KJ ligaments were analyzed. The injury of lateral collateral ligament was combined in 18 patients with posterior cruciate ligament rapture, in 25 patients with anterior cruciate ligament rapture, in 8 patients all 3 injuries were diagnosed. Neurolysis was performed in 16 patients (48.5 %), neurorraphy in 2 patients (6.1 %), plastics of nerve in 4 patients (12.1 %), orthopedic reconstruction in 6 patients (18.1 %), neurolysis and orthopedic reconstruction in 4 patients (12.1 %), plastics of nerve with orthopedic reconstruction in 1 patient (3.1 %). Results: primarily a ligament reconstruction to stabilize KJ and then the revision of injured PN were performed. In cases of posterior instability of KJ plastics of posterior cruciate ligament was performed under arthroscopic control. In case of anterior cruciate ligament injury plastics of ligament was performed under arthroscopic control using titanium and biodegradable fixation device. In case of anatomic injury of PN treatment tactics depended upon the length of damage, condition of nerve ends and surrounding soft tissues. Conclusion: to restore the function of lower extremity in patients with the injury of KJ ligaments combined with PN injury the set of surgical intervention should be done. Restoration of KJ stability should be always done initially. Reconstruction of its ligaments should be performed with revision and restoration of PN.


peronael nerve; traction injury; treatment algorithm; suturing; plastics; reconstruction


Hecht B. M. Theoretical and clinical electromyography / B. M. Hecht. — L .: Nauka, 1990. — 229 p.

Dyatlov M. Traumatic dislocation of the tibia, complicated by damage to the nerves of trunk / M. M. Dyatlov, S. I. Kirilenko // Medical News. — 2006. — № 6. — P. 111–114.

Strafun S. Clinical and electromyographic stages of denervation-reinnervation process in limb muscle with damaged peripheral nerves / S. S. Strafun, O. G. Gayko // Injury. — 2012. — Vol 13, № 4. — P. 121–127.

Fomin G. N. Traumatic injury of the sciatic nerve (clinical picture, diagnosis and surgical treatment): atoref. Of PhD Thesis. Med. Science / G. N. Fomin. — Kyiv, 1999. — 15 p.

Electromyography in the diagnostics of neuromuscular diseases / B. M. Hecht, Kasatkina L. F., M. I. Samoilov, A. G. Sanadze. — Taganrog: TRTRU, 1997. — 370 p.

Biomechanical analysis of an isolated fibular (lateral) collateral ligament reconstruction using an autogenous semitendinosus graft / B. Coobs, R. F. LaPrade, C. Griffith, B. J. Nelson // Am. J. Sports Med. — 2007. — Vol. 35 (9). — P. 1521–1527.

Displacement of the common peroneal nerve in posterolateral corner injuries of the knee / N. Bottomley, A. Williams, R. Birch [et al.] // J. Bone Joint Surg. Br. — 2005. —

Vol. 87-B (9). — P. 1225–1226.

Hegyes M. S. Knee dislocation. Complications of nonoperative and operative management / M. S. Hegyes, M. W. Richardson, M. D. Miller // Clin. Sports Med. — 2000. — Vol. 19 (3). — P. 519–543.

Johnson M. E. Neurologic and vascular injuries associated with knee ligament injuries / M. E. Johnson, L. Foster, J. C. DeLee // Am. J. Sports Med. — 2008. — Vol. 36 (12). — P. 2448–2462, doi: 10.1177/0363546508325669.

LaPrade R. F. Injuries to the posterolateral aspect of the knee: association of anatomic injury patterns with clinical instability /

R. F. LaPrade, G. C. Terry // Am. J. Sports Med. — 1997. — Vol. 25 (4). — P. 433–438.

Liveson J. A. Laboratory reference for clinical neurophysiology / J. A. Liveson, D. M. Ma. — N. Y.: Oxford University Press, 1992. — 513 p.

Niall D. M. Palsy of the common peroneal nerve after traumatic dislocation of the knee / D. M. Niall, R. W. Nutton, J. F. Keating // J. Bone Joint Surg. Br. — 2005. — Vol. 87-B. —

P. 664–667.

Results of 14 nerve grafts of the common peroneal nerve after a severe valgus strain of the knee / A. Durandeau, Ch. Piton, Th. Fabre [et al.] // J. Bone Joint Surg. Br. — 1997. — Vol. 79-B, Suppl. I. — P. 54.

Sisto D. J. Complete knee dislocation. A follow-up study of operative treatment / D. J. Sisto, R. F. Warren // Clin. Orthop. —

— Vol. 198. — P. 94–101.

Sunderland S. Nerves and nerve injuries / S. Sunderland. — Edinburgh: Churchill Livingstone, 1972. — 362 p.

Surgical treatment of traumatic peroneal nerve lesions / J. A. Seidel, R. Koenig, G. Antoniadis [et al.] // Neurosurgery. — 2008. — Vol. 62 (3). — P. 664–673, doi: 10.1227/01.neu.0000317315.48612.b1.

Taylor A. R. Traumatic dislocation of the knee: a report of forty-three cases with special references to conservative treatment / A. R. Taylor, G. P. Arden, H. A. Rainey // J. Bone Joint Surg. Br. — 1972. — Vol. 54 (1). — P. 96–102.

Wascher D. C. High-velocity knee dislocation with vascular injury: treatment principles / D. C. Wascher // Clin. Sports Med. — 2000. — Vol. 19 (3). — P. 457–477.

Copyright (c) 2015 Sergey Strafun, Vasyl Gayovich, Oksana Gayko, Oleksandr Strafun

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.