Health Encyclopedia - Diseases and Conditionship replacement procedures. The two most important prognostic variables are the level and type of injury.
Fracture dislocation of the hip, or simple dislocations, frequently traumatize the peroneal component of the sciatic nerve due to the lateral position of the peroneal nerve fibers. Hip dislocation is a true orthopedic emergency, and immediate reduction (repositioning of bone) is indicated.
Frequently, the palsy (weakness) will resolve spontaneously. However, with posterior wall or posterior column acetabular (the ball of the hip joint) fractures, the nerve may become entrapped in fracture fragments, necessitating careful exploration at the time of surgery.
Complete transection (cutting through) of the peroneal nerve at high levels may cause additional loss of part or all of the biceps femoris function of the hamstrings. The prognosis for functional return of the foot is generally poor with those injuries that require surgical repair or nerve grafting.
foot Drop
Paralysis (weakness) of the common peroneal nerve results in foot drop and inversion (turning inward) of the foot. The patient cannot dorsiflex (lift up) the ankle, straighten or extend the toes, or evert (turn the foot outward). Walking is characterized by overflexion of the knee and slapping of the foot on the floor (called a steppage gait.) Sensory loss may be present as well.
Treatment
The patient should be informed of the injury to the nerve and a plan should be outlined for treatment and follow-up. The acute management depends on the type of injury, but a dorsiflexion cast or splint may be necessary to hold the foot in a neutral position during the recovery phase.
A very functional type of orthosis (brace) is the inexpensive polypropylene ankle-foot orthosis with removable Velcro straps.
When assessing recovery after an injury, muscle activity can be noted for the first time at the distal aspect of the fibula (the lower part of the smaller leg bone). The peroneal muscles that evert (turn outward) the foot are the first to return, followed by the anterior tibial muscle group.
Questions To Ask Your Doctor
Are there any tests that need to be done to diagnose the condition?
How are these tests performed?
What is the cause of the condition?
Can the condition resolve spontaneously?
What treatment will you recommend?
Will you be prescribing medication?
What are the side effects?
How effective is the treatment?
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