Current Concepts Review: Common Peroneal Nerve Palsy After Knee Dislocations

Christopher J. Dy, Paul M. Inclan, Matthew J. Matava, Susan E. Mackinnon, Jeffrey E. Johnson

Research output: Contribution to journalReview articlepeer-review

Abstract

Dislocation of the native knee represents a challenging injury, further complicated by the high rate of concurrent injury to the common peroneal nerve (CPN). Initial management of this injury requires a thorough neurovascular examination, given the prevalence of popliteal artery injury and limb-threatening ischemia. Further management of a knee dislocation with associated CPN palsy requires coordinated care involving the sports surgeon for ligamentous knee reconstruction and the peripheral nerve surgeon for staged or concurrent peroneal nerve decompression and/or reconstruction. Finally, the foot and ankle surgeon is often required to manage a foot drop with a distal tendon transfer to restore foot dorsiflexion. For instance, the Bridle Procedure—a modification of the anterior transfer of the posterior tibialis muscle, under the extensor retinaculum, with tri-tendon anastomosis to the anterior tibial and peroneus longus tendons at the anterior ankle—can successfully return patients to brace-free ambulation and athletic function following CPN palsy. Cross-discipline coordination and collaboration is essential to ensure appropriate timing of operative interventions and ensure maintenance of passive dorsiflexion prior to tendon transfer.

Original languageEnglish
Pages (from-to)658-668
Number of pages11
JournalFoot and Ankle International
Volume42
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • Bridle procedure
  • common peroneal nerve
  • dislocation
  • foot drop
  • knee
  • palsy

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