From the Guidelines
Peroneal nerve injury is a potential complication that can cause significant morbidity, including sensory loss or foot drop, and should be avoided during microphlebectomy procedures. The term "perone" is not a recognized medical term, but it appears to be related to the peroneal nerve, which is a significant anatomical structure. According to the most recent and highest quality study, 1, microphlebectomy involves the surgical excision of pathologic vessels and can be associated with complications such as skin blistering, wound infections, and nerve injuries, including the common peroneal nerve.
Key Considerations
- The common peroneal nerve is located near the fibular head and can be injured during microphlebectomy, leading to sensory loss or foot drop 1.
- Care or avoidance of this region is recommended when planning microphlebectomy to minimize the risk of nerve injury 1.
- Early functional treatment is advised for lateral ankle sprains to address proprioception, muscle response time, and muscle strength, enabling early return to sport participation 1.
Clinical Implications
- Healthcare providers should be aware of the potential complications associated with microphlebectomy, including peroneal nerve injury, and take steps to minimize this risk.
- Patients undergoing microphlebectomy should be informed of the potential risks and benefits of the procedure, including the risk of nerve injury.
- Further research is needed to fully understand the implications of peroneal nerve injury and to develop effective strategies for prevention and treatment.
From the Research
Peroneal Tendon Overview
- Peroneal tendon disorders are commonly mistaken for or occur concomitantly with lateral ankle sprains, with varus hindfoot being a known risk factor for peroneal tendinopathy 2
- Treatments for peroneal tendon disorders include immobilization, laterally posted orthotics, and physical therapy for progressive tendon loading 2
Corticosteroid Injections
- Ultrasound-guided peroneal tendon sheath corticosteroid injection is a nonoperative modality for treating chronic tendinopathy or tears, with limited data on its safety and efficacy 3
- A systematic review found that corticosteroid injections into tendon sheaths, including peroneal tendons, may provide at least short-term improvement in pain, but controlled studies are required to fully demonstrate efficacy 4
- A survey of AOFAS members found that peroneal tendonitis was injected 54% of the time, with complications including skin depigmentation, atrophy, and flare reaction being observed 5
Rehabilitation and Surgery
- Rehabilitation after surgical treatment of peroneal tendon tears and ruptures is an important factor in clinical success, with a trend towards shorter immobilization time and early range of motion 6
- The duration of immobilization and start of range of motion exercises vary depending on the type of surgical treatment, with no consensus on best practice recommendations for optimizing rehabilitation 6
- A study found that 25% of patients progressed to have surgery on their peroneal tendons following ultrasound-guided corticosteroid injection, with preinjection duration of symptoms associated with postinjection duration of pain relief 3