CHU La Rabta, Faculté de médecine de Tunis, Chirurgie plastique, réparatrice et chirurgie de la main, Jabbari, Tunis 1007, Tunisia.
Orthop Traumatol Surg Res. 2013 Oct;99(6):719-22. doi: 10.1016/j.otsr.2013.05.004. Epub 2013 Aug 27.
Common peroneal nerve (CPN) entrapment at the fibular head is the most common nerve entrapment syndrome at the lower limbs. Motor deficits predominate and the risk of persistent functional impairment is the main concern. The objective was to evaluate outcomes of neurolysis and to evaluate the benefits of performing surgery early.
We retrospectively reviewed the medical charts of 15 patients (mean age, 32 years) treated with neurolysis. The diagnosis was idiopathic CPN entrapment in ten patients, indirect nerve injury with CPN paralysis due to an ankle injury in three patients, and postural CPN compression in two patients. Mean time to management was 7 months (range, 2-18 months).
Mean follow-up after neurolysis was 42 months (range, 25 to 62 months). The outcome was considered excellent in seven cases, good in five cases, and fair in three cases. Mean time to functional recovery was 2.5 months (range, 2 weeks to 6 months). Of the ten patients with idiopathic CPN entrapment syndrome, nine had excellent or good outcomes. The three patients with fair outcomes had ankle injuries or polyneuropathy.
Spontaneous recovery can take time and remain incomplete. We prefer to perform surgery between the third and fourth months in patients with persistent symptoms or incomplete recovery, even in forms confined to sensory dysfunction documented by electrophysiological testing. Time to recovery is shorter after surgical decompression than with rehabilitation therapy.
Level IV, retrospective study.
腓总神经（CPN）在腓骨头处受压是下肢最常见的神经受压综合征。运动功能障碍为主，持续功能障碍的风险是主要关注点。目的在于评估神经松解术的结果，并评估早期手术的益处。
我们回顾性分析了 15 例接受神经松解术治疗的患者（平均年龄 32 岁）的病历。10 例诊断为特发性 CPN 受压，3 例因踝关节损伤导致间接神经损伤和 CPN 瘫痪，2 例为姿势性 CPN 压迫。平均治疗时间为 7 个月（范围为 2-18 个月）。
神经松解术后平均随访 42 个月（范围为 25 至 62 个月）。7 例疗效为优，5 例为良，3 例为可。功能恢复的平均时间为 2.5 个月（范围为 2 周至 6 个月）。在 10 例特发性 CPN 受压综合征患者中，9 例的疗效为优或良。3 例疗效为可的患者有踝关节损伤或多发性神经病。
自发性恢复可能需要时间且仍不完整。我们倾向于在持续症状或不完全恢复的患者中在第 3 至第 4 个月进行手术，即使在电生理检查记录的感觉功能障碍范围内也是如此。与康复治疗相比，手术减压后恢复时间更短。
IV 级，回顾性研究。
