Functional outcome after peroneal nerve injury.

The objective of this study was to describe muscle strength, ankle-foot orthosis (AFO) use, walking ability, participation and quality of life in patients with peroneal nerve injury. A historic cohort study (n=27) was performed with a median follow-up time of 61 months (inter quartile range 37-91). Muscle strength was assessed using the Medical Research Council scale. Perceived walking ability was assessed with the Walking Questionnaire. AFO use and problems in participation were assessed with a structured interview. The RAND-36 Health Survey was used to evaluate health-related quality of life. Muscle strength improved significantly during follow-up but 62% (16 of 26 patients, one missing value) of the patients still had paresis to some degree of ankle dorsiflexors. AFO use decreased significantly but 11% (n=3) still used an AFO at follow-up. Two-thirds (n=18) of the study population experienced some limitations in walking and climbing stairs. Decreased maximum walking distance was reported by 59 % (n=16). About half of the patients (n=13) reported some restrictions in leisure activities and 47% (n=9) of the patients with a paid job (n=19) experienced some restrictions in work. Scores on the domains physical functioning, mental health, vitality, bodily pain and general health perception of the RAND-36 were significantly lower compared with a Dutch reference group. Limitations in walking ability and participation are frequently present 5 years after peroneal nerve injury. Health-related quality of life was lower than in a reference group.

Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment.

This is a multicenter study on peroneal mononeuropathy (PM), in which a multidimensional protocol was performed to evaluate (1) the predisposing factors and their occurrence; (2) the relationships between the etiological, clinical, and neurophysiologic findings; and (3) disability and quality of life (QoL) in a wide sample with PM. Clinical and neurophysiologic evaluation was performed in all patients; moreover, the group adopted validated disability and QoL measurements to obtain more comprehensive and reliable data on PM. From November 2002 to January 2004, 69 patients were enrolled consecutively in 11 Italian centers. Our data showed that PM involves men more frequently than women (male : female = 4.1:1). PM was idiopathic (16%) or due to prolonged posture (23.1%), surgery (20.3%), weight loss (14.5%), trauma (11.6%), bedridden condition (7.3%), external compression from cast (5.8%), and arthrogenic cyst at the fibula (1.4%). Unexpectedly, peroneal nerve lesions were not only due to surgical operation close to the peroneal region but were also associated with thoracic-abdominal surgery. We observed conduction block in about 50-70% of postural and weight loss PM; in perioperative and idiopathic PM, conduction block or mixed damage was equally present; in PM due to trauma, we observed an exclusive axonal damage in about 60% of cases. Only in three cases (one postural PM, one idiopathic PM, and one weight loss PM), we observed a slowing of conduction velocity in the popliteal fossa-fibular head segment without conduction block. The comparison between QoL in patients with PM and in healthy subjects showed a significant involvement of physical and mental aspects. With regard to disability, 68% of patients walked with difficulty. Our data show that (1) most of the cases of PM are due to an identifiable predisposing factor; (2) there is a good correlation between predisposing factors and clinical-neurophysiologic findings; and (3) PM causes disability and deterioration of the physical and emotional aspects of QoL.