Peroneal nerve palsy resulting from fibular head osteochondroma

Peroneal nerve palsy resulting from fibular head osteochondroma

This article describes a case of a 11-year-old boy with an osteochondroma of the peroneal head causing peroneal nerve palsy. Physical examination disclosed large exostoses palpated at the right fibular head. Neurological examination revealed paresis of the tibialis anterior, lateral peroneal, and ex...

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Published in:Orthopedics (Thorofare, N.J.) Vol. 32; no. 7; pp. 528 - 530
Main Authors: Mnif, Hichem, Koubaa, Mustapha, Zrig, Makram, Zammel, Nizar, Abid, Abderrazek
Format: Journal Article
Language:English
Published: United States SLACK INCORPORATED 01-07-2009
Subjects:
Bone Neoplasms - complications
Bone Neoplasms - surgery
Bone surgery
Child
Cysts
Decompression, Surgical - methods
Fibula - surgery
Fractures
Humans
Injuries
Male
Neurological disorders
Osteochondroma - complications
Osteochondroma - surgery
Patients
Peroneal Neuropathies - etiology
Peroneal Neuropathies - surgery
Trauma
Treatment Outcome
Tumors
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Summary:This article describes a case of a 11-year-old boy with an osteochondroma of the peroneal head causing peroneal nerve palsy. Physical examination disclosed large exostoses palpated at the right fibular head. Neurological examination revealed paresis of the tibialis anterior, lateral peroneal, and extensor digitorum muscles with a muscle strength grade of 2. Electrophysiological studies confirmed denervation of the muscles supplied by the right peroneal nerve. Radiological examination showed an osteochondroma in the head of the right fibula. The patient underwent surgical decompression of the right peroneal nerve after resection of the bone tumor. At 36-month follow-up, there was a complete recovery of the deficits. Peroneal mononeuropathy in children is uncommon. Osteochondroma is a benign tumor consisting of projecting bone capped by cartilage. These tumors may be solitary or multiple and occur in hereditary multiple exostoses syndrome. The conjunction of this lesion with peroneal nerve palsy has been exceptionally reported for children, usually linked to hereditary multiple exostoses syndrome. Most peroneal nerve trauma occurs at the fibular head, where the common nerve has not yet divided into its deep and superficial peroneal nerve and where most peroneal nerve lesions, therefore, involve both branches, although motor deficits are more frequently involved than sensory ones. Surgical treatment should not be delayed because neurological improvement may be achieved if surgery is performed before severe neurological deficits become irreversible.
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ISSN:0147-7447
1938-2367
DOI:10.3928/01477447-20090527-24