Thursday, February 28, 2013

Nerve II

A 30 year old woman undergoes a prolonged pelvic surgery in lithotomy position. Post-operatively, she is noted to have acute foot drop. She cannot dorsiflex her foot against resistance; in order to walk, she has to flex her hip higher when walking. She also complains of loss of sensation over the top of her foot. Although she cannot evert her foot, inversion is preserved.

Challenge: Where's the lesion?

Image shown under Creative Commons Attribution Share-Alike License, from Wikipedia.

3 comments:

sibogox said...

Peroneal nerve lesion. common peroneal nerve specifically.

sid said...

Prolonged Compression of the Common peroneal nerve by the stirrups against the head of the fibula.. Sensory symptoms occurring in this lady are in the region supplied by the superficial peroneal nerve (i think)..

Craig said...

well done! you guys know this stuff better than me!
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Nerve II

This is injury to the common peroneal nerve just below the knee as the nerve wraps around the lateral fibula.

Source: UpToDate.