Can MR neurography of the common peroneal nerve predict a residual motor deficit in patients with foot drop?

The effects of mirror therapy with neuromuscular electrical stimulation on motor and sensory functions in patients with common peroneal nerve injury

Background

Injuries to the common peroneal nerve often result in significant sensory and motor function loss, severely affecting patients' quality of life. Although existing treatments, including medication and surgery, provide some degree of efficacy, their effectiveness is limited by factors such as tolerance and adverse side effects.

Methods

This study aims to evaluate the effects of a 4-week regimen of mirror therapy combined with neuromuscular electrical stimulation on lower limb function, muscle strength, and sensation in patients with common peroneal nerve injuries. The objective is to identify novel therapeutic strategies for lower limb peripheral nerve injuries.30 patients with Common peroneal nerve caused by pelvic fractures were selected from the Rehabilitation Medicine Department of Tianjin Hospital between July 2023 and July 2024. They were randomly divided into two groups: the neuromuscular electrical stimulation group (n = 15) and the mirror therapy with neuromuscular electrical stimulation group (n = 15).

Results

After 4 weeks, it was found that mirror therapy with neuromuscular electrical stimulation has a significantly better therapeutic effect on Common peroneal nerve than simple electrical stimulation therapy, particularly in terms of superficial sensation, nerve conduction velocity and ROM.

Functional outcomes of different surgical treatments for common peroneal nerve injuries: a retrospective comparative study

BACKGROUND

This study aims to assess the recovery patterns and factors influencing outcomes in patients with common peroneal nerve (CPN) injury.

METHODS

This retrospective study included 45 patients with CPN injuries treated between 2009 and 2019 in Jing'an District Central Hospital. The surgical interventions were categorized into three groups: neurolysis (group A; n = 34 patients), nerve repair (group B; n = 5 patients) and tendon transfer (group C; n = 6 patients). Preoperative and postoperative sensorimotor functions were evaluated using the British Medical Research Council grading system. The outcome of measures included the numeric rating scale, walking ability, numbness and satisfaction. Receiver operating characteristic (ROC) curve analysis was utilized to determine the optimal time interval between injury and surgery for predicting postoperative foot dorsiflexion function, toe dorsiflexion function, and sensory function.

RESULTS

Surgical interventions led to improvements in foot dorsiflexion strength in all patient groups, enabling most to regain independent walking ability. Group A (underwent neurolysis) had significant sensory function restoration (P < 0.001), and three patients in Group B (underwent nerve repair) had sensory improvements. ROC analysis revealed that the optimal time interval for achieving M3 foot dorsiflexion recovery was 9.5 months, with an area under the curve (AUC) of 0.871 (95% CI = 0.661-1.000, P = 0.040). For M4 foot dorsiflexion recovery, the optimal cut-off was 5.5 months, with an AUC of 0.785 (95% CI = 0.575-0.995, P = 0.020). When using M3 toe dorsiflexion recovery or S4 sensory function recovery as the gold standard, the optimal cut-off remained at 5.5 months, with AUCs of 0.768 (95% CI = 0.582-0.953, P = 0.025) and 0.853 (95% CI = 0.693-1.000, P = 0.001), respectively.

CONCLUSIONS

Our study highlights the importance of early surgical intervention in CPN injury recovery, with optimal outcomes achieved when surgery is performed within 5.5 to 9.5 months post-injury. These findings provide guidance for clinicians in tailoring treatment plans to the specific characteristics and requirements of CPN injury patients.