Patient Case Studies
Pre-Operation Foot Drop Video
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Post-Operation Foot Drop Video
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Case study 1:
A 62 year old woman who underwent a right hip replacement surgery suffered a foot drop injury as a result of stretching of the sciatic and peroneal nerves during placement of the artificial hip. The nerve was stretched high up at the level of the hip joint, so that effective regeneration of the nerve down to the tibialis anterior muscle of the leg would take over a year; by that time the tibialis anterior muscle would have been permanently paralyzed.
In this case, Dr. Nath used one of the branches of the adjacent tibial nerve and reeouted it to the peroneal nerve. Because the distance for regeneration of the tibial nerve into the peroneal nerve is very short, the potential for reversal of the foot drop is good. This patient spent one night in the hospital and 6 months later noticed ankle movement. One year after surgery she had a complete resolution of the foot drop. This is seen in the before and after videos above this section.
Case study 2:
An 18-year-old all- state high school football player received a full athletic scholarship to the University of Texas. In his final game in high school, he suffered major ligament injury to his right knee requiring surgical reconstruction. At the time of the injury, he also was noted to have a foot drop.
The patient underwent ligament reconstruction successfully and began physical therapy. He recovered fully from the ligament injury but one year later still had the foot drop. His athletic scholarship was lost due to inability to walk effectively; running was not possible at all.
At this point he was referred to my office and I performed a decompression and scar removal of the peroneal nerve at the level of the knee.
Three months later, the patient was able to run without brace assistance. Six months later he regained his athletic scholarship and went on to play with the team successfully.
Case study 3:
A 45 year old woman spent a Saturday hiking though a park in Texas. There was no trauma and no history of falling or other injury to the leg. The day following the hiking, she awakened with a foot drop. Electrical testing of the peroneal nerve showed a complete block of function at the level of the knee.
The patient's local neurologist counseled her to begin physical therapy, but did not suggest a surgical consultation.
One year later, the patient still had a complete foot drop and was given no diagnosis or hope for improvement by her neurologist. She sought out consultation with me about 14 months after the onset of her foot drop. I operated on her for decompression of the peroneal nerve at he fibular neck.
One week after surgery the patient recovered movement in the ankle in the upward direction. Three months after surgery she regained full function of her ankle and was back to normal activities, including hiking. In this case, the injury was due to swelling of the soft tissues and muscles around the peroneal nerve as a result of hiking. The peroneal nerve runs in a tight tunnel around the neck of the fibula ,and swelling of the surrounding tissues can compress and stop the nerve from working. Surgery opens up the tunnel and allows the nerve to expand and begin working again.
Case study 4:
A 42 year old man worked as a driver for a delivery company. During his work while driving, he had a habit of leaning his left leg against the door. One morning he awakened with a foot drop as a result of swelling of the tissues around the tunnel of the peroneal nerve at he knee. Surgical decompression resulted in complete resolution of symptoms within 3 weeks.
Case study 5:
A 54 year old woman underwent surgery on the lower back for a herniated disk that had been causing pain. On awakening from the surgery, she noted a foot drop as a result of pressure on the roots of the peroneal nerve during surgery. Six months later there had been no recovery of function at the ankle.
The patient underwent a tibial to peroneal nerve transfer at the level of the knee. Six months after the nerve transfer she was able to lift her ankle and one year after nerve transfer she was walking normally. |
