Risk Factors for Peroneal Nerve Injury and Recovery in Knee Dislocation

Christopher J. Peskun MD, Jas Chahal MD, Zvi Y. Steinfeld BSc, Daniel B. Whelan MD
Symposium: Complex Knee Ligament Surgery
Volume 470, Issue 3 / March , 2011

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Abstract

Background

Acute knee dislocation is rare but has a high rate of associated neurovascular injuries and potentially limb-threatening complications. These include the substantial morbidity associated with peroneal nerve injury: neuropathic pain, decreased mobility, and considerably reduced function, which not only impairs patient function but complicates treatment.

Questions/purposes

We therefore identified and quantified the risks associated with specific factors for peroneal nerve injury and recovery in patients with knee dislocations.

Patients and Methods

We retrospectively reviewed the charts of 26 patients, from among a cohort of all 91 knee dislocations, with a peroneal nerve palsy over a 5-year period. We then used univariable and multivariable statistics to identify risk factors predicting peroneal nerve injury and recovery.

Results

Gender (odds ratio, 5.47), body mass index (odds ratio, 1.14), and fibular head fracture (odds ratio, 4.77) were associated with peroneal nerve injury. Only younger age was associated with peroneal nerve recovery.

Conclusions

Knowledge of the risk factors for peroneal nerve injury and the predictors of recovery in knee dislocation allows the treating surgeon to have a better understanding of the nature of the neurologic injury and modify management based on the anticipated return of nerve function.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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