Carpal Tunnel of the Leg


PHILADELPHIA, Pa. (Ivanhoe Newswire) – Normal foot function is something you don’t think about until it’s gone. Carpal tunnel of the leg.

Common peroneal nerve dysfunction can be caused by sudden trauma or injury to the knee. It affects how the leg feels and how the foot functions. For one young college athlete, when physical therapy didn’t work, a complex surgery made all the difference.

Twenty-two-year-old Erin Moran loves to run. But over a year ago, this college student suddenly lost feeling in her right leg.

“It was hard. I was tripping everywhere. I was falling, I wasn’t able to drive,” Moran explains.

The first doctor Erin and her mom visited told Erin she might never walk normally again. That’s when she was referred to neurosurgeon, Dr. Zarina Ali. Dr. Ali diagnosed Erin with common peroneal nerve dysfunction.

(Read Full Interview)

Dr. Ali says, “I commonly explain it to patients as sort of the carpal tunnel of the leg.”

Erin’s peroneal nerve, which runs along the side of the knee, was compressed, causing the numbness and foot drop. After months of physical therapy had no effect, Dr. Ali recommended decompression surgery.

“What we are doing is opening up the area of where that nerve can get entrapped under the muscle fascia,” Dr. Ali describes to Ivanhoe.

Erin’s surgery was an outpatient procedure. Dr. Ali cautioned her that recovery could take up to a year. But just four months after surgery, Erin began jogging and, on a whim, she did a 10-mile race in October.

“I felt so good that I came home and ran another seven miles,” Erin expressed.

With Dr. Ali’s blessing, Erin signed up to run the Philadelphia marathon.

Erin remembers, “When I hit a point where I didn’t think I could put one foot in front of another, I just looked down at my leg and at my scar, and kind of just tapped it for some good luck.”

That “good luck tap” worked and she finished the entire 26.2-mile race with a smile on her face.

Dr. Ali says many patients, like Erin, often recover fully from common peroneal nerve dysfunction. Erin says she plans to run another marathon again this fall.

Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #5049

BACKGROUND: The peroneal nerve is one branch of the sciatic nerve. It supplies movement and sensation to the lower leg, feet, and toes. The most common peroneal nerve dysfunction is a type of peripheral neuropathy, or damage to nerves outside the brain or spinal cord. There can occur the dysfunction of a single nerve, such as the common peroneal nerve. This is called a mononeuropathy, which means the nerve damage occurred in one area. Certain body-wide conditions can also cause single nerve injuries such as trauma or injury to the knee; fracture of the fibula; use of a tight plaster cast of the lower leg; crossing the legs regularly; regularly wearing high boots; pressure to the knee from positions during deep sleep or coma; and injury during knee surgery or from being placed in an awkward position during anesthesia.


SYMPTOMS AND TREATMENT: Symptoms of peroneal nerve disfunction may include decreased sensation, numbness, or tingling in the top of the foot or the outer part of the upper or lower leg; foot that drops; a “slapping” gait; toes that drag while walking; walking problems; weakness of the ankles or feet; and loss of muscle mass because the nerves aren’t stimulating the muscles. A doctor may prescribe some tests of nerve activity. These may include electromyography (EMG); nerve conduction tests; magnetic resonance imaging (MRI); or nerve ultrasound. Treatment options aim to improve mobility and independence. In some cases, corticosteroids injected into the area may reduce swelling and pressure on the nerve. Surgery may be needed if the disorder does not go away; you have problems with movement; or there is evidence that the nerve axon is damaged.


BREAKTHROUGH FOR NERVE DAMAGE: Researchers in Ireland have found a potential new approach to repairing peripheral nerve defects using extracellular matrix (ECM) proteins. These proteins play an important role in tissue formation. Researchers used a new ECM-loaded nerve guidance conduit in the trial, which showed an improved recovery response at eight weeks following the repair of traumatic nerve lacerations with substantial loss of tissue. Results showed there was increased pro-repair inflammation, blood vessel density, and regenerating nerve density compared to the current standard of care. “Our conduit supported clear improvements in nerve repair and blood vessel formation and, most importantly, we saw that we could scale this up to approach very large nerve defects in our pre-clinical studies,” said lead authors Alan Hibbitts, MD and Zuzana Kočí, MD.



Kelsey Odorczyk

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Doctor Q and A

Read the entire Doctor Q&A for Dr. Zarina Ali, MD, assistant professor of neurosurgery

Read the entire Q&A