Advertisement - Hide this advert





Author Topic: Peroneal Nerve Surgery  (Read 9981 times)

0 Members and 1 Guest are viewing this topic.

Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Peroneal Nerve Surgery
« on: May 04, 2012, 11:53:50 AM »
I am the mother of a 22 year old Rugby player who has sustained bad knee injury resulting in torn PCL ACL meniscus , and fracture of his Tibia. He also dislocated his knee and now has foot drop. It is 10 weeks since the injury. His knee is doing well, but no improvement in the nerve damage. He has had one EMG at 8 weeks and the result was not good. Only about 2 percent of nerve conduction  below the fibular head. So the possibility of surgery is looming. My problem is , we live in Ireland, and as its a small country, and this is not a common injury we don't have a centre of excellence for nerve surgery/repair, so I need to take him abroad. I have identified 2 or 3 excellent Doctors in the US but as aftercare and therapy is so important , it would be better if we could find a Doctor who specialized and has lots of experience and practice in Nerve repair, Nerve transfer/graft in the UK. Has anyone out there had a nerve transfer done of the Peroneal Nerve in the UK? I have been told the Wellington Hospital is good. If so how did it go? My son's next EMG is in 3 to 4 weeks. If there is not a marked improvement in the result, his Neurologist has said he will recommend exploration of the nerve. I want to be ready with to go with the right surgeon.........as it is important to have surgery between 3 and 6 months to obtain the best possible result.

Any help with this would be very much appreciated........I'm tearing my hair out here!!!

Offline Stasha83

  • Forum Faithful
  • ****
  • Posts: 226
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #1 on: May 08, 2012, 12:21:02 PM »
Hi

I had peripheral nerve surgery in February with Dr Marco Sinisi at the Wellington Hospital in London. He was brilliant, I can't recommend him enough.

The surgery was big and the incision bigger than I expected but he had to deal with 3 nerves. My progress was slow, at first I thought that maybe the surgery hadn't helped but now I feel that a large amount of my nerve pain has gone. I still have pain and a few other issues but this surgery was a big help. It may be that I need further surgey in the future as I have a niggling feeling that I still have some nerve related issues but I am glad I had this procedure.

I would warn you that his fees are expensive and my insurance did not fully cover them. I would suggest calling his secretary, he is really helpful and he can give you further info.

Good luck, I hope you find a solution for your son.
« Last Edit: May 08, 2012, 12:24:30 PM by Stasha83 »
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline marco4432

  • Regular Poster
  • ***
  • Posts: 67
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #2 on: May 10, 2012, 09:13:58 PM »
I have had two failed knee surgeries in Las Vegas, My Doctor trained under Dr Dellon, my advice don't do it maybe as he is younger it will work but my surgeon only saye I cant belive I missed the nerves twice, Thanks Doc gret help
R Knee Arthospic  06/01/2010, partial lateral menisectomy synvisc injections
Start of dibilitating pain after operation
Ri knee Arthosopic Meniscus tear 03/13/11
partial lateral menisectomy synvisc
 Nerve Surgery09/15/2011Right knee
12/23/11 CT scan nerve block
02/29/12 2nd failed nerve surgery

Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #3 on: May 23, 2012, 08:55:36 AM »
Hi

I had peripheral nerve surgery in February with Dr Marco Sinisi at the Wellington Hospital in London. He was brilliant, I can't recommend him enough.

The surgery was big and the incision bigger than I expected but he had to deal with 3 nerves. My progress was slow, at first I thought that maybe the surgery hadn't helped but now I feel that a large amount of my nerve pain has gone. I still have pain and a few other issues but this surgery was a big help. It may be that I need further surgey in the future as I have a niggling feeling that I still have some nerve related issues but I am glad I had this procedure.

I would warn you that his fees are expensive and my insurance did not fully cover them. I would suggest calling his secretary, he is really helpful and he can give you further info.

Good luck, I hope you find a solution for your son.

Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #4 on: May 23, 2012, 09:03:30 AM »
Hi Stasha83,

Thank you for your reply. Since I last posted my son has had another EMG/nerve conduction study and there is no improvement  unfortunately, so the neurologist is now recommending exploration of the nerve. We are going to see Mr Mike Fox at the wellington hospital and also Professor Thomas Carlstedt and the Royal National Orthopedic hospital in London, and also a plastic surgeon in Ireland called Kevin Cronin who does nerve surgery. We are also thinking of going to see Dr Eric Zager at Pennsylvania university hospital. It is a really big decision to pick the right surgeon to give my son every chance of recovering full movement of his lower right leg. Once again , anyone have experience of any of these Doctors for Peroneal nerve repair surgery????

Offline higginsj1

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #5 on: June 25, 2012, 03:20:03 PM »
Hi

In Sept 2011 I tore my ACL and posterior lateral corner (PLC) resulting in foot drop. I had two EMG and nerve tests one at 6weeks which showed nothing and then another at 6 months which again showed nothing. In the time between these tests my surgeon would not operate on my knee to repair the ligament damage, so i went to see a top knee surgeon Mr Steve Bollen in bradford, who has operated on all the top football and rugby players including niall quinn and roy keane. He reconstructed my ACL and PLC and told me after the op my peroneal nerve was stretched and not severed so in time it will regenerate but very slowly 1 inch per month. 1yr down the line i started getting little dorsflexion movements and now after 18months i'm nearly back to full movement apart from my big toe which he did say would be last. I am currently back playing football with little problems.

Has he had his ligaments repaired??? if so was the nerve severed. If not and he has a postive tinels sign surgery is not recommeded and the nerve will regenerate but very slowly and can take upto 2yrs to recover.

Hope this helps.



Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #6 on: June 25, 2012, 09:45:01 PM »
Hi Higgins,

Thank you so much for your message. My son had virtually no Tinel's sign so after a recommendation by his Neurologist and 4 peripheral nerve surgeons to have surgery, we went ahead and he had Neurolysis of his peroneal nerve with Mr Mike Fox at the Wellington Peripheral nerve injury unit, with Mr Marco Sinisi assisting. It was not torn but stretched and had a lesion of about 5 centimetres, and was impacted with scar tissue. There was clear conduction across the lesion which was a good sign, and definitely nerve fascicles in continuity, so they decided not to graft the nerve but just decompress and await spontaneous recovery. Mr Fox said the nerve would not have recovered without intervention as it was so compressed in scar tissue. So we now have a long wait to see if the nerve re grows. Can you tell me did you use a stimulation machine and also what kind of physical therapy did you have. I am so delighted for you that you have made such a good recovery, and it also gives me hope for my son.

I'll say a prayer for your Toe!

Offline higginsj1

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #7 on: July 02, 2012, 03:20:24 PM »
Hi

I had no tinels sign until about 2-3months after my injury and it started slowly to progress down my leg. I was given a neuro 4 stimulator which i used daily for about 1yr and then i had to give it back. I dont know whether it helped or not some people say it does others say not. My surgoen didnt say how much it was stretched or whether there was scar tissue, i presume if there was he cleared it out. I had pyhsio 3 times a week but that was for my ACL and PLC rehab and i did my own ankle exercises at home to keep it mobile by using a towel. I also had AFO which i stopped wearing about 8months ago.

Has your son had his ligaments reconstructed??? or just the nerve surgery.

Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #8 on: July 09, 2012, 04:17:37 PM »
Hi Higgins,

Yes Stu had surgery to repair his ACL,PCL and torn meniscus 3 day's after the injury. The surgeon did not explore the nerve at the time as he did not want to interfere with the blood supply. But at 3 months with absolutely no Tinel's sign , nerve surgery was recommended. Stu has the same stim machine as you, and uses it every day for 3 hours, he also does the ankle excersises. But his physio works on his Tibialis anterior muscle and his ankle flexion also. Your story gives me great hope for him. He has a definite Tinel's sign now and increased electric shock like pain down in to his toes, I guess you had that pain too.? He got a new AFO from Denovo healthcare the other day. It's called the Dynamic AFO and he loves it. Its comfortable and he can run , jump and take stairs properly in it. His walk is also totally normal when he wears it, you wouldn't know he had foot drop at all.
Thank you so much for telling me your story, its very good to hear about your recovery.

all the best, V

Offline TricKnee

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #9 on: July 09, 2012, 06:15:21 PM »
To the mother of the 22year old Rugby player.  I suffered a knee dislocation playing Rugby last year, with the dislocation came a Peroneal Nerve tear.  It broke in two, they found this our when they went into fix the knee.  I had a plastic surgeon put it back together and outlook is bad for the foot drop.  I am still hoping.  A couple things I have learned.  The lower extremities are very bad for nerve grafts or transfers.  The medical community know very little about nerves so be careful if they want to do a transfer, it has some cons and the results might not be all that great.  I am currently working with an acupuncturist to try and regrow the nerve.  The best thing you have is age, the younger you are the better chance you have for regrowth.  I am 40 and they do not have much hope for me.  The exploratory surgery is probably a good idea just to know if it is just stretched or broken completely. 

I wish you the best of luck!

Offline jp_Irishguy

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #10 on: December 04, 2012, 08:07:11 PM »
Hi. I have an appointment to see Mr. Cronin probably some time in the new year. I don't have much information on Mr. Cronin and I was hoping that you might be able to give me some feedback on him, I was wondering if you were refered to him by any of the well known OS who specialise in knee injuries as in Ray Moran or Brian Hurson? I have health insurance but I still don't think that I will be able to afford to go to the Wellington Clinic in London. I have also heard of a neurosurgeon  Jabir Nagaria who does do peripheral nerve surgery in the Hermitage Clinic but I am not sure if he does the peroneal nerve procedure? Any help would be much appreciated.
Kind Regards.
James

Offline determined

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #11 on: December 20, 2012, 06:10:56 PM »
Hi James,

I'm so sorry to hear of your injury. First of all the surgery in the Wellington was not that expensive, the surgeon only charged 1,200 pounds, and the anaesthetist 350. The overnight in the hospital was the most expensive at 2,000.  But my son just had a decompression of his nerve to release it from scar tissue, as his nerve was stretched and not torn. If it had been torn , we were looking at a nerve graft or transfer which would probably have beem more expensive. However our insurance VHI covered half of the cost. It is really well worth going to the surgeons who have the most experience in this type of surgery. My son had his surgery in may and 5 months almost to the day he felt his first bit of movement. He was studying at college and felt the tendons on top of his foot moving. Next thing to move was his middle toe about 4 weeks ago and now he can dorsiflex his foot about an inch.... So his surgery has definitely worked. Best Christmas present ever for my boy and for me. Mr Mike Fox at the Wellington performs these operations on peripheral nerves on a daily basis, and let face, practice makes perfect. We have wonderful surgeons here of which Mr Cronin is one, and I believe a very fine surgeon. But if at all possible I would consult with Mr Fox also,. The UK is a big country with a bigger pool of injured people so the surgeons get plenty of work with which to perfect their skills. It is important to point out also that the E stim machine and Physio are also vital for recovery. My son plugs himself I. Every day for about 3 hours and is very diligent about doing his Physio to work his Tibet Ant now that the nerve has connected with it.

I wish you the very best of luck, don't hang around and get the most experienced surgeon if you want to have the best result. You can email me if you need to know anything else, I did a lot of research at the time , and would be happy to help you in any way that I can.

Val

Offline Stapleford

  • MICROgeek (<20 posts)
  • *
  • Posts: 1
  • Liked: 0
Re: Peroneal Nerve Surgery
« Reply #12 on: July 12, 2014, 06:51:44 PM »
There I a nerve centre in Birmingham at the queen Elizabeth Hospital. nerve transfer surgery for foot drop is offered there.