Technical NoteRepetitive Plantar Flexion Test as an Adjunct Tool for the Diagnosis of Common Peroneal Nerve Entrapment Neuropathy
Section snippets
Study Population
All patients gave prior written informed consent for participation in this retrospective analysis of prospectively collected data. They were consecutive patients whose CPNEN was improved by PN neurolysis. The diagnosis of ipsilateral CPNEN was based on symptoms, such as numbness and/or pain from the lower leg to the dorsum of the foot, which appeared upon walking or standing and produced intermittent claudication. The Tinel sign of the PN around the neck of the fibula was positive in all
Participants
Between September 2013 and January 2015, we surgically treated 39 consecutive patients with CPNEN (Table 1). From our study we excluded 17 patients; 9 had bilateral CPNEN, 4 presented with dementia or psychological problems, 1 had Parkinson disease, and 3 manifested severe arteriosclerosis obliterans. The exclusion of 2 additional patients with unsatisfactory surgical outcomes was based on the assumption that the original diagnosis of CPNEN was incorrect. As we also excluded 2 patients who
Discussion
PN neuropathy is the most common peripheral neuropathy of the lower extremities and the most frequent cause of numbness and pain in the lower limbs. CPNEN surgery yielded good results.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 The causes of PN neuropathy are multiple; it can be the result of previous orthopedic procedures and leg trauma. According to Dellon et al6 most large case series included a sizeable number of patients in whom no particular cause for their common peroneal neuropathy could be
Conclusions
Our simple RPF test elicited symptoms in patients with CPNEN. We suggest that our provocation test as an adjunct diagnostic tool for CPNEN as the origin of intermittent claudication.
Acknowledgments
We are grateful to Toshinori Yusa for her contribution to the electrophysiologic studies.
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