Application Of Neuro-ultrasound In Common Peroneal Nerve Entrapment Secondary To Sciatic Nerve Injury

Background: Sciatic nerve injury often leads to motor and sensory dysfunction of the lower extremities,which seriously affects the daily life of patients.Studies have shown that distal common peroneal nerve decompression can significantly improve the curative effect of sciatic nerve injury caused by artificial hip arthroplasty and improve patients’ symptoms such as foot ptosis,which is related to the secondary entrapment of the distal common peroneal nerve at the head of fibula after high sciatic nerve injury.At present,there is no auxiliary examination to confirm the mechanism of secondary compression of the common peroneal nerve.This paper focuses on the diagnostic value of neuro-ultrasound in the secondary compression of the common peroneal nerve and the postoperative effect of neuro-decompression on such patients.Methods: The study is divided into two parts.The first part prospectively included patients with high sciatic nerve injury who were treated in the second affiliated Hospital of Nanchang University from September 2020 to March 2023.The cross-sectional area of the common peroneal nerve at the fibular head of the patients was compared with that of healthy volunteers to explore the applicability of ultrasound to this kind of patients.The second part retrospectively analyzed the surgical effect of distal common peroneal nerve decompression in patients with high sciatic nerve injury.MRC grade,MCRR standard,FMA score and Maryland score were used to evaluate the function before and after operation.Results: A total of 28 patients were included in the ultrasonic diagnosis study group.The ratio of the affected side to the healthy side of the common peroneal nerve in the study group and the ratio of the left side to the right side in the control group were analyzed by t-test,and the results showed significant statistical difference.19 patients were included in the operation group,and 15 patients were followed up effectively.In 12 patients(80%),the muscle groups of the anterior tibial group and lateral group recovered well(MRC ≥ 3),and 9 cases(60%)basically returned to normal function(MRC ≥ 4).Conclusion: The study of ultrasonic diagnosis shows that most of the patients with secondary injury of common peroneal nerve have morphological changes under ultrasound,indicating that ultrasonic diagnosis has a strong reference value for clinical diagnosis of such patients.These patients were followed up for at least 6months,and most of them recovered well,indicating that one of the reasons for the poor recovery of patients with high sciatic nerve injury was related to the secondary entrapment of the common peroneal nerve.obvious curative effect can be obtained after surgical release of the common peroneal nerve at the head of the fibula.