Peroneal nerve compression by lateral gastrocnemius flap

James R. Sanger, Dennis S. Kao, Donald A. Hackbarth

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish (US)
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume62
Issue number8
DOIs
StatePublished - Aug 2009

Fingerprint

Peroneal Nerve
Peroneal Neuropathies
Denervation
Skeletal Muscle
Knee Prosthesis
Neuroma
Muscles
Fascia
Thigh
Tibia
Paralysis
Knee
Wounds and Injuries

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 journalArticle

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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.

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KW - Rotational flap

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