Abstract
Background A proximal deep peroneal nerve (DPN) injury can significantly impact the functional
capacity of the leg, to include compromised motor function of the tibialis anterior
(TA) muscle. Clinical examination can range from weakness in ankle dorsiflexion, to
complete foot drop. Diagnostic nerve conduction velocity (NCV) testing can demonstrate
abnormalities at select areas of impingement (or) entrapment (i.e., regions affected
by a demyelinating compression mono-neuropathy), along the proximal course of the
common peroneal nerve.
Methods We retrospectively report on 17 patients with clinical weakness involving ankle dorsiflexion.
All patients underwent surgical end-to-side anastomosis, transferring a muscular nerve
branch from the superficial peroneal nerve (SPN) to a segment of the DPN responsible
for TA muscle innervation. Outcomes were based on comparisons of preoperative and
postoperative DPN motor function to the TA muscle, standardized to the British Medical
Research Council Scale for Muscle Strength. Preoperative scores were generally M2
or below.
Results Postoperative outcome scores of M4 to M5 were considered good (or) successful. 94.1%
of patients demonstrated successful outcomes.
Conclusion An end-to-side SPN motor branch anastomosis, into the motor branch of the DPN responsible
for TA muscle innervation, can be a viable treatment option for weakness in ankle
dorsiflexion. All reported cases involved a compromised segment of deep peroneal nerve
within the proximal one-third of the leg.
Keywords
weakness - ankle dorsiflexion - deep peroneal nerve
