Abstract
Lateral gastrocnemius muscle flaps are reliable flaps routinely used to cover defects in the lower thigh, the knee, and the upper third of the tibia. Peroneal neuropathy following lateral gastrocnemius flap has been described previously and mostly attributed to intraoperative nerve injury. However, compression of the nerve by the flap itself has not been reported. A 56-year-old female developed right common peroneal nerve palsy 10 months after a lateral gastrocnemius flap rotation for knee prosthesis coverage. Surgical exploration found a common peroneal nerve neuroma under a compressive band formed by the lateral fascial edge of the rotated gastrocnemius muscle. The motor nerve of the flap was not denervated. When stimulated, muscle contracted and compressed the common peroneal nerve underneath. Excision of the lateral fascia and selective motor denervation were performed. Postoperatively, the patient's symptoms improved. To prevent compressive common peroneal neuropathy from lateral gastrocnemius rotational flaps, we recommend fascial excision from the lateral aspect of the muscle and selective motor denervation.
| Original language | English (US) |
|---|---|
| Journal | Journal of Plastic, Reconstructive and Aesthetic Surgery |
| Volume | 62 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2009 |
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Keywords
- Common peroneal nerve
- Compression
- Lateral gastrocnemius flap
- Neuropathy
- Peroneal nerve
- Rotational flap
ASJC Scopus subject areas
- Surgery
Cite this
Peroneal nerve compression by lateral gastrocnemius flap. / Sanger, James R.; Kao, Dennis S.; Hackbarth, Donald A.
In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 62, No. 8, 08.2009.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Peroneal nerve compression by lateral gastrocnemius flap
AU - Sanger, James R.
AU - Kao, Dennis S.
AU - Hackbarth, Donald A.
PY - 2009/8
Y1 - 2009/8
N2 - Lateral gastrocnemius muscle flaps are reliable flaps routinely used to cover defects in the lower thigh, the knee, and the upper third of the tibia. Peroneal neuropathy following lateral gastrocnemius flap has been described previously and mostly attributed to intraoperative nerve injury. However, compression of the nerve by the flap itself has not been reported. A 56-year-old female developed right common peroneal nerve palsy 10 months after a lateral gastrocnemius flap rotation for knee prosthesis coverage. Surgical exploration found a common peroneal nerve neuroma under a compressive band formed by the lateral fascial edge of the rotated gastrocnemius muscle. The motor nerve of the flap was not denervated. When stimulated, muscle contracted and compressed the common peroneal nerve underneath. Excision of the lateral fascia and selective motor denervation were performed. Postoperatively, the patient's symptoms improved. To prevent compressive common peroneal neuropathy from lateral gastrocnemius rotational flaps, we recommend fascial excision from the lateral aspect of the muscle and selective motor denervation.
AB - Lateral gastrocnemius muscle flaps are reliable flaps routinely used to cover defects in the lower thigh, the knee, and the upper third of the tibia. Peroneal neuropathy following lateral gastrocnemius flap has been described previously and mostly attributed to intraoperative nerve injury. However, compression of the nerve by the flap itself has not been reported. A 56-year-old female developed right common peroneal nerve palsy 10 months after a lateral gastrocnemius flap rotation for knee prosthesis coverage. Surgical exploration found a common peroneal nerve neuroma under a compressive band formed by the lateral fascial edge of the rotated gastrocnemius muscle. The motor nerve of the flap was not denervated. When stimulated, muscle contracted and compressed the common peroneal nerve underneath. Excision of the lateral fascia and selective motor denervation were performed. Postoperatively, the patient's symptoms improved. To prevent compressive common peroneal neuropathy from lateral gastrocnemius rotational flaps, we recommend fascial excision from the lateral aspect of the muscle and selective motor denervation.
KW - Common peroneal nerve
KW - Compression
KW - Lateral gastrocnemius flap
KW - Neuropathy
KW - Peroneal nerve
KW - Rotational flap
UR - http://www.scopus.com/inward/record.url?scp=67650074846&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650074846&partnerID=8YFLogxK
U2 - 10.1016/j.bjps.2007.12.013
DO - 10.1016/j.bjps.2007.12.013
M3 - Article
C2 - 18222740
AN - SCOPUS:67650074846
VL - 62
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
SN - 1748-6815
IS - 8
ER -