Penetrating injuries to the nerves of the lower extremity: principles of diagnosis and treatment.

Background. Lower extremity nerve injuries caused by wounds are often not noticed immediately after trauma. The purpose of this article was to analyze the localization of penetrating injuries to the nerves, the mechanism and extent of the lesions, and the microsurgical techniques used. The diagnostic and therapeutic basics in penetrating injuries of lower extremity nerves are also described. Material and methods. The clinical material consisted of 67 patients treated surgically for penetrating injuries of lower extremity nerves. Results. In our material we observed penetrating injuries to the common peroneal nerve (41 cases), tibial nerve (9 cases), sciatic nerve (6 cases), combined common peroneal and tibial nerves (8 cases), and miscellaneous (foot injuries, 3 cases). The mechanism of injury included 51 cases of neurotmesis (primary injuries) and 16 cases of nerve compression (secondary injuries). In 5 cases, lesions of the major vessels and common peroneal and tibial nerves were observed. Conclusions. Penetrating injuries to the common peroneal nerve are the most frequent lesions of the peripheral nervous system within the lower limbs. The early detailed inspection of wounds, especially those localized in areas posing a particular threat to peripheral nerves, is an essential part of surgical treatment.