• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.29-35
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• 2004

Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

• Physical Therapy Korea
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• v.31 no.1
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• pp.18-28
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• 2024

Background: Lateral instability of the ankle is one of the most common causes of musculoskeletal ankle injuries. The peroneus longus (PL) and peroneus brevis (PB) contribute to ankle stability. In early rehabilitation, isometric exercises have been selected for improvement of ankle stability. To effectively train the peroneal muscles during eversion, it is important to consider ankle and body posture. Objects: This study aimed to compare activation of the PL, PB, and biceps femoris (BF) muscles during eversion in different ankle postures (neutral [N], plantarflexed [PF]) and body postures (sitting and side-lying). Methods: Thirty healthy individuals with no history of lateral ankle sprains within the last 6 months were included in the study. Maximal isometric strength of eversion and muscle activation were measured simultaneously. Muscle activation at submaximal eversion was divided by the highest value obtained from maximal isometric eversion among the four postures (percent maximal voluntary isometric contraction [%MVIC]). To examine the differences in muscle activation depending on posture, a 2 × 2 repeated measures analysis of variance (ANOVA) was conducted. Results: There were significant interaction effects of ankle and body postures on PL muscle activation and evertor strength (p < 0.05). The PL muscle activation showed a significantly greater difference in the side-lying and PF conditions than in the sitting and N conditions (p < 0.05). Evertor strength was greater in the N compared to the PF condition regardless of body posture (p < 0.05). In the case of PB and BF muscle activation, only the main effects of ankle and body posture were observed (p < 0.05). Conclusion: Among the four postures, the side-lying-PF posture produced the highest muscle activation. The side-lying-PF posture may be preferred for effective peroneal muscle exercises, even when considering the BF muscle.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.509-515
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• 2018

Objective : In Asians, kneeling and squatting are the postures that are most often induce common peroneal neuropathy. However, we could not identify a compatible compression site of the common peroneal nerve (CPN) during hyper-flexion of knees. To evaluate the course of the CPN at the popliteal area related with compressive neuropathy using magnetic resonance imaging (MRI) scans of healthy Koreans. Methods : 1.5-Tesla knee MRI scans were obtained from enrolled patients and were retrospectively reviewed. The normal populations were divided into two groups according to the anatomical course of the CPN. Type I included subjects with the CPN situated superficial to the lateral gastocnemius muscle (LGCM). Type II included subjects with the CPN between the short head of biceps femoris muscle (SHBFM) and the LGCM. We calculated the thickness of the SHBFM and posterior elongation of this muscle, and the LGCM at the level of femoral condyles. In type II, the length of popliteal tunnel where the CPN passes was measured. Results : The 93 normal subjects were included in this study. The CPN passed through the "popliteal tunnel" formed between the SHBFM and the LGCM in 36 subjects (38.7% type II). The thicknesses of SHBFM and posterior portions of this muscle were statistically significantly increased in type II subjects. The LGCM thickness was comparable in both groups. In 78.8% of the "popliteal tunnel", a length of 21 mm to <40 mm was measured. Conclusion : In Korean population, the course of the CPN through the "popliteal tunnel" was about 40%, which is higher than the Western results. This anatomical characteristic may be helpful for understanding the mechanism of the CPNe by posture.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.62-64
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• 2012

Superficial peroneal nerve entrapment is an uncommon compression neuropathy, and is frequently associated with a fascial defect and a muscle hernia. The standard treatment of that was the nerve decompression by complete or limited fasciotomy. But, we experienced a case of superficial peroneal nerve entrapment had satisfactory surgical outcome by fascial repair of peroneus muscle.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.67-76
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• 2019

Objectives : The purpose of this study was to explore the effectiveness of Korean medicine treatment and the Muscle Energy Technique on foot drop through a case study with a patient with common peroneal neuropathy. Methods : A patient with severe foot drop after an ankle sprain was hospitalized and treated with acupuncture and traditional medicine and the Muscle Energy Technique. The effect of the treatment was evaluated with the Numeric Rate Scale(NRS), dorsiflexion angle evaluation, and the Manual Muscle Test (MMT). Results : The results of the NRS, dorsiflexion angle evaluation and MMT showed greatly improvementwith results changing from 8 to 2, 0 to 15, and Grade 2 to Grade 4, respectively. Conclusions : This study suggests that Korean medicine treatment and the Muscle Energy Technique could be effective treatments for foot drop with common peroneal neuropathy. However further clinical studies are needed to establish a definite conclusion.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.4
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• pp.46-56
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• 2016

Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique (MET) for peroneal nerve palsy after normal delivery. Methods: Two patients with peroneal nerve palsy were treated with acupuncture, moxibustion, cupping and MET. MET was performed in piriform, gluteus medius, anterior tibial and adductor muscles. To evaluate the effect of MET, we analyzed Ankle dorsiflexion range of motion (ROM), Manual Muscle Test (MMT), Numerical Rating Scale (NRS) and Ankle Hindfoot Scale (AHS). Results: In Case 1, ROM score was changed from −5 to 20, and MMT score was changed from 0 to 4. NRS score was changed from 5 to 1, and her AHS score was changed from 54 to 94 after treatment. In Case 2, ROM score was changed from 0 to 20, and her MMT score was changed from 1 to 5. NRS score was changed from 4 to 1, and her AHS score was changed from 64 to 97 after treatment. Conclusions: MET may be a useful treatment for patients who, shortly after childbirth or while breastfeeding, strongly refuse to treat the irritation.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.3
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• pp.127-136
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• 2015

Objectives This study was carried out to investigate the clinical effects of Korean medical treatment on acute peroneal nerve palsy caused by prolonged immobilization. Methods One patient with acute peroneal nerve palsy was treated with various korean medical techniques such as acupuncture, moxibustion, cupping and herbal medicine, bee-venom acupuncture for 12 weeks. Manual Muscle Test, Range of motion, Numerical Rating Scale, Ankle-hindfoot scale, Digital infrared thermographing imaging system were used to evaluate treatment effect. Results After treatment, all the scales mentioned above were improved significantly. Conclusions This result showed that Korean medical treatment is effective on acute peroneal nerve palsy caused by prolonged immoblization.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.585-587
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• 2007

Peroneal neuropathy presenting at birth is a rare disorder. Although neonatal mononeuropathies may be related to obstetrical complications, prenatal mechanisms should be also considered. We describe an infant who was born at term by cesarean section due to breech presentation with a unilateral footdrop. Lack of compound muscle action potential in the peroneal nerve and denervation potentials confined to the tibialis anterior and the extensor hallucis longus muscles in the electrophysiological studies on the fourth day of life strongly suggest an isolated peroneal neuropathy of intrauterine onset. Early and sequential electrodiagnostic studies will be important to provide better temporal and pathophysiologic definitions, the better timing of onset and prognosis for mononeuropathies presenting in newborn infants.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.187-192
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• 2006

The perforator flaps are based on cutaneous vessels which are originated from a main pedicle and penetrate fascia or muscle to reach the skin. The lateral lower leg is one of the most suitable areas for harvesting perforator flaps because a number of perforator vessels exist. The authors applied peroneal perforator flaps in nine patients. Five flaps were reverse island flaps based on peroneal artery and septocutaneous perforator, and four flaps were free flap based on musculocutaneous perforator only. The recipient site was the posterior ankle in three patients, posterior heel in three patients, lateral malleolus, anterolateral ankle, and foot dorsum in one patient each. The flap size ranged from 5 to 12cm long, from 3 to 5cm wide, and the primary closure of the donor site was possible in most cases. All flaps, except for the flap in two patients in the reverse island flap series, survived completely. The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized superficial skin defects. Also, this flap may be considered as an alternative to radial forearm flap or other perforator flaps.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.668-674
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• 2017

Objective: This case report describes the effects of Korean medicine treatment on chronic peroneal nerve palsy. Methods: One patient with peroneal nerve palsy was treated 6 months after onset with various Korean medicine treatments, such as acupuncture, cupping, herbal medicine (Bojungikki-tang and Palmijihwang-tang), and Hominis Placental pharmacopuncture for 14 days. The Manual Muscle Test (MMT), range of motion (ROM) of the ankle, and a numerical rating scale (NRS) were used to evaluate the effectiveness of treatment. Results: After 14 days of treatment, the scores for all 3 scales were improved. The MMT grade increased from 1-3 to 4-4+. The ankle ROM was restored to a nearly normal range. The NRS showed a considerable improvement, decreasing from 7 to 2. No side effects were noted. Conclusions: Korean medicine may be effective for the treatment of chronic peroneal nerve palsy, but further studies are needed.