Preventable iatrogenic cause of foot-drop in knee injuries with literature review

Abstract

Purpose: Common peroneal nerve palsy is quite disabling and every effort should be made to prevent its injury during the treatment.

Methods: We retrospectively reviewed the prospectively collected data of 7 cases of tibial plateau fractures in association with proximal fibula fracture from January 2019 to September 2019 who presented to emergency room of our hospital.

Results: In addition to fibular neck fracture, the first case had type 6 tibial plateau displaced fracture and the second case had displaced acetabular fracture with instability of knee with tibial tuberosity avulsion. common peroneal nerve palsy developed following application of distal tibial skeletal traction in both the cases. Other 6 such cases remained neurologically intact as traction was not applied to them.

Conclusion: Such iatrogenic complication could have been prevented if the injury pattern of "concomitant medial and lateral columns" of the proximal leg is kept in mind by the treating surgeon before applying skeletal traction.

Keywords: Common peroneal neuropathies; Proximal fibula fractures; Tibial plateau fractures; Traction palsy.