Yukiko Morimoto*, Yusuke Sogabe, Akira Kawabata and Kiyohito Takamatsu
Department of Orthopedic Surgery, Yodogawa Christian Hospital, JapanFulltext PDF
We experienced a case of recurrent adhesion neuropathy after neurolysis.
There are some reports on recurrent peripheral nerve palsy. Among them, a substantial number of investigators have mentioned treatment of recurrent carpal tunnel syndrome by covering with muscles, flaps, and adiposal flaps. However, there is no report on the use of a perforator adiposal flap for recurrent peroneal nerve palsy. We experienced a case of reoperation for recurrence after
neurolysis for peroneal nerve palsy and good recovery of the paralysis by wrapping the peroneal nerve with a gastrocnemius muscle perforator adiposal flap. A 50-year-old man had an accident, following which he was diagnosed with right tibial nerve and peroneal nerve palsy. Two months after the injury, we performed neurolysis of the tibial and peroneal nerves. After the procedure,
muscle strength showed a tendency toward recovery; however, muscle weakness of the peroneal nerve recurred. The patient was diagnosed with recurrent peroneal nerve palsy due to adhesion neuropathy. Eleven months after the first procedure, secondary neurolysis of the peroneal nerve was performed. During the second procedure, after performing the neurolysis, we covered the peroneal nerve with a gastrocnemius muscle perforator adiposal flap (70 mm × 60 mm) to prevent recurrent adhesion. Twelve months after the second procedure, the muscles on the affected side recovered as much strength as the muscles on the healthy side.
Based on these findings, we concluded that adhesion could be effectively prevented by wrapping the nerve with an appropriate flap in addition to neurolysis in patients with adhesion neuropathy.
Morimoto Y, Sogabe Y, Kawabata A, Takamatsu K. A Gastrocnemius Muscle Perforator Adiposal Flap to Wrap the Peroneal Nerve for Recurrent Peroneal Nerve Adhesion Neuropathy: A Case Report. Ann Plast Reconstr Surg. 2021;5(1):1073..