Peroneal Mononeuropathy Treatment & Management

Updated: May 22, 2017
  • Author: Shaheen E Lakhan, MD, PhD, MS, MEd; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Treatment

Medical Care

Most peroneal nerve lesions respond to conservative management with rest and elimination of triggering factors such as leg crossing. Physical therapy is helpful in recovery of function. A large Italian study showed good spontaneous improvement in patients with peroneal mononeuropathy and rehabilitation helped with recovery of deambulation. [31] Additionally, ankle foot orthosis (AFO) helps to stabilize the gait and prevent tripping due to the foot drop.

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Surgical Care

Evaluation for surgical intervention for peroneal nerve repair is rarely necessary except in the following situations:

  • The lesion is due to a mass compressing the nerve.
  • Release of nerve tethering is indicated.
  • Severe or complete transection is suspected as with blunt or open trauma.

A group from Turkey has reported good results after tibialis posterior tendon transfer for persistent foot drop after peroneal nerve repair. [32]

Another group has reported good results from patients with deep peroneal nerve injuries resulting in foot drop undergoing nerve transfer of functional fascicles of either the superficial peroneal nerve or of the tibial nerve as donor for deep peroneal-innervated muscle groups. [33]

A group from Italy has reported good motor improvement with a double tendon transfer method from the tibialis posterior to tibialis anterior, and flexor digitorum longus transfer to the extensor digitorum longus and extensor hallucis longus tendons. [34]

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