Percutaneous nerve compression syndrome

　　Because the common peroneal nerve is fixed and does not move at the neck of the fibula, located beneath the skin, and its deep surface is the tough fibula, it is most prone to compression at this location. The causes of the common peroneal nerve compression syndrome are usually as follows:

　　1, Trauma:The most common, often seen in fractures of the head and neck of the fibula, fractures of the lateral condyle of the tibia, foot inversion injury, and lateral soft tissue injury of the popliteal fossa.

　　2, Chronic injury:Commonly seen in long-term squatting, sitting cross-legged, kneeling, and inward foot deformity, etc. These conditions can all cause the fibularis longus muscle to be overly tense, leading to compression of the common peroneal nerve by the tendinous tissue at its origin.

　　3, Iatrogenic factors::Also common in clinical practice, such as plaster and splint compression.

　　4, Tumor:Tumors at the head and neck of the fibula, such as giant cell tumors, chondroma, hemangiomas, and tendons of the biceps femoris and tendons of the fibularis longus at the origin, as well as bursitis at the origin of the fibularis longus.

　　5, Other:Unexplained compression.

　　The common peroneal nerve compression syndrome can directly cause the muscles innervated by the common peroneal nerve to appear weakness, numbness, tingling, and other abnormal sensations. Due to the long-term loss of nerve nutrition to the muscles, it can cause atrophy of the gastrocnemius muscle. Secondly, the common peroneal nerve usually has two branches, the lateral branch and the medial branch. According to the severity of the injury, it can cause corresponding changes in the foot. Lateral branch injury can cause foot inversion, and medial branch injury can cause "clubfoot".

　　Patients with chronic injury of the common peroneal nerve compression syndrome initially complain of pain on the lateral side of the lower leg, which worsens during walking and relieves after rest. Subsequently, there is a gradual onset of acid and soreness, weakness, and fatigue on the lateral side of the lower leg and the top of the foot, with a decrease or disappearance of sensation. The paralysis of the tibialis anterior muscle, the extensor digitorum longus muscle, the extensor hallucis longus muscle, and the peroneus longus muscle to varying degrees can cause foot drop and mild inversion. Acute compression patients often experience sensory disturbance on the lateral side of the lower leg and the top of the foot, and foot drop after a single local compression.

　　In patients with complete injury caused by compression of the common peroneal nerve, foot drop can be seen. Walking presents a gait of leaping over, with sensory disturbance on the lateral side of the lower leg and the top of the foot, as well as disorders of toe extension, toe extension, dorsiflexion of the foot, and inversion and eversion of the foot. The atrophy of the anterior and lateral muscle group of the lower leg can also occur.

　　The compression of the common peroneal nerve is usually caused by trauma, iatrogenic injury, tumor compression, and other reasons, and is mainly prevented according to the etiology. High-risk workers, such as construction workers and miners, are prone to injury and should pay attention to protecting themselves during work. Stay calm in the face of problems to avoid emotional excitement leading to conflict and causing the disease. Medical workers should improve their surgical skills and pay attention to protecting the common peroneal nerve during the external fixation and surgery of knee and fibula fractures.

　　The diagnosis of peroneal nerve entrapment syndrome relies not only on clinical and physical signs but also on electromyography to understand the location and extent of the injury, and at the same time, it can exclude other diseases. X-ray films of the knee joint in this disease can reveal bony changes.

　　Patients with peroneal nerve entrapment syndrome should eat more spinach, oil vegetables, shepherd's purse, winter melon, bamboo shoots, bitter melon, fresh lotus root, celery, chrysanthemum flowers, wheat, mulberry, pear, peach, sunflower seeds, mung bean, longan, eggs, mutton, duck meat, black-bone chicken, honey, glutinous rice, sticky rice, millet, soybean and its products, barley, carrots, pumpkin, tomatoes, dairy products, ginseng, crucian carp, mandarin fish, pork liver, pork stomach, beef, sheep heart, rabbit meat, pigeon eggs, sticky rice, jujube, lily, hawthorn seeds, wolfberry, silver ear, goose meat, pork lung, pancreas, winter melon, bitter melon, eggplant, crucian carp, etc.
　　Patients should also pay attention to avoid long-term use of painkillers. The dietary therapy for this disease includes Schisandra pigeon egg:
　　50 grams of Schisandra fruit decoction, 30 pigeon eggs, boil and peel, then soak in the Schisandra fruit decoction for 2 days. Eat 3 pigeon eggs each time, once or twice a day, and heat and boil before eating. Generally, take it for about 2 weeks.

　　In the conservative treatment of peroneal nerve entrapment syndrome, anti-inflammatory and analgesic drugs, local block, corrective brace to fix the ankle in varus position, and auxiliary electrical stimulation and neurotrophic drug therapy are applied. For those who have no recovery of nerve function and ineffective conservative treatment after one month of observation after the removal of external compressive factors, early surgical treatment should be performed. This disease can also be treated with peroneal nerve exploration and release surgery. If the peroneal nerve has been completely degenerated and fibrotic, then nerve resection and nerve transplantation surgery of the lesion segment is required. For advanced patients, if the ankle joint function is normal and there is no bony change, tenotomy can be performed, such as the transfer of the posterior tibial muscle to the extensor digitorum longus. If there is already bony change in the ankle joint, then bony surgery is required, such as triple arthrodesis.