Aapects of surgical treatment of diseases and injuries of the peroneal nerve

INTRODUCTION. The paper considers the possibilities of surgical treatment of diseases and injuries of the peroneal nerve, which are based on the analysis of a comprehensive examination and surgical treatment of 143 patients with injuries and diseases of the peroneal nerve in 2009–2020 operated in Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre.

AIM. To evaluate the possibilities of surgical treatment of diseases and injuries of the peroneal nerve.

MATERIALS AND METHODS. Among the patients, men predominated 60.3% in the age group from 21 to 50 years (48 %). Compressive-ischemic neuropathies of the peroneal nerve (CIMN) were detected in 41 (28.7 %) cases, space-occupying lesions of the peroneal nerve were detected in 7 (4.9 %) cases, closed traction injuries (CIMN) of the peroneal nerve (dislocation in the knee joint) were noted in 22 (15.4 %) patients, open injuries of the peroneal nerve were detected in 31 (21.6 %) cases, neuropathy of the peroneal nerve as a result of closed injuries (NMNRLD) in 31 (21.6 %) cases.

RESULTS. The variants of surgical treatment depending on the etiology of the peroneal nerve lesion were studied. After the surgical treatment and processing of the obtained results, the analysis showed that a significant regression of neurological symptoms and an improvement in ENMG parameters in the immediate postoperative period was detected in groups of patients with tumors of the peroneal nerve and CINMN (p<0.01), in contrast to the groups of patients with MTMT, open injuries of the peroneal nerve where the results appear no earlier than 6 months after surgical treatment. And they are quite comparable with the results of treatment of patients with NMNRZD. The pain syndrome is similar to that in lesions of the spinal nerve root at the level of the L5 vertebra in lateral stenosis. A thorough clinical examination with Tinel’s sign at the level of the fibular head and an ankle re-extension test allows a correct diagnosis of peroneal dysfunction and, accordingly, reduces the incidence of ineffective surgical interventions on the lumbar spine. The proposed technique for severe diastasis of the peroneal nerve after excision of intratruncal neuromas (patent RF No. 2766800 dated March 15, 2022) is an effective method of surgical treatment.

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