Common Peroneal Nerve Entrapment Neuropathy

The common peroneal nerve runs around the fibular head in a shallow subcutaneous layer. It can be externally compressed by the rigid fibula at the bottom and it is fixed by fibrous tissue where it passes through a tunnel composed of the peroneus longus- and soleus muscle, and it is affected by dynamic factors. When the nerve is impaired by external compression, relatively strong paralysis and drop foot may develop. In the presence of impairment due to dynamic factors (idiopathic disease), sensory impairment is the main symptom; motor weakness may be absent or slight. In patients with intermittent numbness and pain elicited by standing and walking, it can be difficult to differentiate between common peroneal nerve neuropathy and lumbar spine disease. Common peroneal nerve conduction studies may not detect common peroneal nerve impairment. Idiopathic disease is not uncommon but may be overlooked; repetitive plantar flexion tests are useful as diagnostic provocation tests. Common peroneal nerve entrapment neuropathy can be treated by less invasive neurolysis under local anesthesia.