Faculty Collaboration Database

Peroneal nerve compression by lateral gastrocnemius flap. J Plast Reconstr Aesthet Surg 2009 Aug;62(8):e280-2

Date

01/29/2008

Pubmed ID

18222740

DOI

10.1016/j.bjps.2007.12.013

Scopus ID

2-s2.0-67650074846 (requires institutional sign-in at Scopus site)   7 Citations

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.

Author List

Sanger JR, Kao DS, Hackbarth DA

Authors

Donald A. Hackbarth MD Adjunct Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bone Neoplasms
Chondrosarcoma
Female
Humans
Knee Joint
Middle Aged
Neuroma
Peroneal Nerve
Peroneal Neuropathies
Reoperation
Surgical Flaps