Peroneal Nerve Injuries and Therapeutic Modalities

Peroneal nerve injury is characterised by weakness of ankle dorsiflexion and foot eversion, often manifesting as foot drop and sensory deficits over the lateral leg and dorsum of the foot. The common peroneal nerve is particularly susceptible to compression at the fibular neck, metabolic insults such as diabetes and mechanical trauma including leg crossing or direct impact. Clinical evaluation combines gait analysis, manual muscle testing and sensory examination, supplemented by electrophysiology (nerve conduction studies and electromyography) and imaging modalities such as magnetic resonance neurography or high-resolution ultrasound. Management spans conservative measures—physiotherapy, orthotic support and functional electrical stimulation—to surgical strategies including nerve decompression, direct nerve repair, nerve transfers and tendon transfers. Emerging techniques harness neuromodulation with pulsed radiofrequency, advanced transcutaneous electrical nerve stimulation and machine learning–driven imaging analysis. Early diagnosis and tailored intervention are essential to restore function, reduce fall risk and enhance quality of life.

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Peroneal Nerve Injuries and Therapeutic Modalities publication trend

The graph below shows the total number of articles in peroneal nerve injuries and therapeutic modalities across all publications each year (not limited to Nature Index journals).

Technical terms

Foot drop: Inability to dorsiflex the ankle during the swing phase, leading to toe drag and compensatory gait patterns.

Transcutaneous electrical nerve stimulation (TENS): Application of low-voltage electrical currents through the skin to stimulate peripheral nerves and muscles.

Pulsed radiofrequency (PRF): Delivery of high-frequency electrical pulses to neuromodulate nerve function without generating thermal ablation.

Deep fibular nerve: A branch of the common peroneal nerve supplying tibialis anterior and extensor muscles of the foot dorsum and adjacent skin.

Tendon transfer: Surgical rerouting of a functioning tendon to replace the action of a paralysed muscle.

Electromyography (EMG): Recording of electrical activity produced by skeletal muscles to assess neuromuscular health and guide management.

References

1. Feasibility of a promising pulsed electrostimulator for rapid motor recovery of foot drop. Heliyon (2024).
2. Deep Learning-Based Knee MRI Classification for Common Peroneal Nerve Palsy with Foot Drop. Biomedicines (2023).
3. Transfer of Soleus Muscular Branch of Tibial Nerve to Deep Fibular Nerve to Repair Foot Drop After Common Peroneal Nerve Injury: A Retrospective Study. Frontiers in Neurology (2022).