Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm.


Journal Article (Review)

Multiligament knee injuries account for <0.02% of all orthopaedic injuries, and 16% to 40% of these patients suffer associated injury to the common peroneal nerve (CPN). The proximity of the CPN to the proximal fibula predisposes the nerve to injury during local trauma and dislocation; the nerve is highly vulnerable to stretch injury during varus stress, particularly in posterolateral corner injuries. CPN injuries have a poor prognosis compared with that of other peripheral nerve injuries. Management is determined based on the severity and location of nerve injury, timing of presentation, associated injuries requiring surgical management, and the results of serial clinical evaluations and electrodiagnostic studies. Nonsurgical treatment options include orthosis wear and physical therapy. Surgical management includes one or more of the following: neurolysis, primary nerve repair, intercalary nerve grafting, tendon transfer, and nerve transfer. Limited evidence supports the use of early one-stage nerve reconstruction combined with tendon transfer; however, optimal management of these rare injuries continues to change, and treatment should be individualized.

Full Text

Cited Authors

  • Mook, WR; Ligh, CA; Moorman, CT; Leversedge, FJ

Published Date

  • June 2013

Published In

Volume / Issue

  • 21 / 6

Start / End Page

  • 343 - 354

PubMed ID

  • 23728959

Pubmed Central ID

  • 23728959

Electronic International Standard Serial Number (EISSN)

  • 1940-5480

International Standard Serial Number (ISSN)

  • 1067-151X

Digital Object Identifier (DOI)

  • 10.5435/jaaos-21-06-343


  • eng