-Case Reports-

Paralysis Immediately after Surgical Decompression for Common Peroneal Nerve Entrapment

Rinko Kokubo¹, Kyongsong Kim¹, Daijiro Morimoto², Toyohiko Isu³ and Akio Morita²

¹Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital
²Department of Neurosurgery, Nippon Medical School
³Department of Neurosurgery, Kushiro Rosai Hospital

Objective: Common peroneal nerve (C-PN) entrapment neuropathy is the most common peripheral nerve neuropathy of the legs. C-PN decompression surgery is less invasive but may result in neurological complications. We report a rare case of nerve paralysis immediately after C-PN decompression surgery.
Case Report: An 85-year-old man presented with leg numbness and pain. An electrophysical study revealed C-PN entrapment in the affected area and he underwent surgical decompression. Immediately after the procedure he complained of slight paralysis without pain (manual muscle test: 3/5), which gradually worsened and was complete at 60 min after surgery. We re-opened the skin incision 3 hours after the first operation and found that a subcutaneous suture had been applied to the connective tissue near the C-PN, resulting in marked compression of the nerve. After release of the suture his paralysis improved immediately. We confirmed that there was no other nerve compression and finished the operation. His paralysis disappeared completely.
Conclusion: Peripheral nerve surgery, including C-PN decompression surgery, is less invasive, and the risk of complications is low. However, because the C-PN is located in the shallow layer under the skin, an excessively deep suture in the subcutaneous layer may compress the nerve and elicit nerve palsy. Therefore, careful postoperative follow-up is necessary because early decompression leads to good surgical results.

J Nippon Med Sch 2023; 90: 237-239

Keywords
common peroneal nerve, drop foot, re-operation

Correspondence to
Rinko Kokubo, MD, PhD, Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
rin-ko927@nms.ac.jp

Received, October 1, 2021
Accepted, November 10, 2021