Daniele Coraci1, Hiroshi Tsukamoto2, Giuseppe Granata3, Chiara Briani4, Valter Santilli1,5, Luca Padua3,6. 1. Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Piazzale Aldo Moro 5, 00185, Rome, Italy. 2. Institute of Neurology, Teikyo University, Tokyo, Japan. 3. Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy. 4. Department of Neurosciences, Sciences NPSRR, University of Padova, Padova, Italy. 5. Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy. 6. Don Carlo Gnocchi Onlus Foundation, Milan, Italy.
Abstract
INTRODUCTION: At least 25% of knee dislocations are associated with common fibular nerve injury. Diagnosis is usually based on clinical and neurophysiological findings. We assessed the role of nerve ultrasound in common fibular nerve injury. METHODS: Eight consecutive patients (6 men and 2 women, mean age 34 years) with knee luxation referred to our laboratory underwent clinical, neurophysiological, and ultrasound examination. RESULTS: In all patients we observed a similar pattern: severe weakness (plegia or severe paresis); neurophysiological involvement of both fibular nerve branches; and ultrasound evidence of increased fibular nerve area with hypoechogenicity. On follow-up evaluation, 6 patients remained stable, and 2 patients improved. The greater the ultrasound fibular nerve enlargement, the worse the recovery. CONCLUSIONS: Nerve ultrasound was confirmed to be a useful diagnostic/prognostic tool in traumatic nerve lesions. A prompt ultrasound examination of the fibular nerve should be considered after any case of knee dislocation.
INTRODUCTION: At least 25% of knee dislocations are associated with common fibular nerve injury. Diagnosis is usually based on clinical and neurophysiological findings. We assessed the role of nerve ultrasound in common fibular nerve injury. METHODS: Eight consecutive patients (6 men and 2 women, mean age 34 years) with knee luxation referred to our laboratory underwent clinical, neurophysiological, and ultrasound examination. RESULTS: In all patients we observed a similar pattern: severe weakness (plegia or severe paresis); neurophysiological involvement of both fibular nerve branches; and ultrasound evidence of increased fibular nerve area with hypoechogenicity. On follow-up evaluation, 6 patients remained stable, and 2 patients improved. The greater the ultrasound fibular nerve enlargement, the worse the recovery. CONCLUSIONS: Nerve ultrasound was confirmed to be a useful diagnostic/prognostic tool in traumatic nerve lesions. A prompt ultrasound examination of the fibular nerve should be considered after any case of knee dislocation.