Superficial peroneal nerve entrapment in AL portal

Impingement Lesions

Description of patient (type of occupation, indication of age, intensity of sport):

Female, 30 years old. Procedure performed: anterior arthroscopic debridment and microfracture of osteochodral lesion of the talus.

History and previous treatment:

Four year ago bimalleolar fracture. Complaints before arthroscopy: limited dorsiflexion, pain and swelling at the ankle joint. walking pain-free few minutes.

Current complaints:

One month after arthroscopy she developed strong tendinitis of the peroneal tendons first and secondary of the tibialis posterior tendon and Achille's tendon. Lasertherapy not possible for increasing pain.
Partial improvement after cortisteroid injection. Now walking pain-free 20 minutes, than acute increasing pain from the lateral aspect of the foot rising the leg.

Physical examination:

No deformitiy. Motility of the ankle joint and of the sub-talar joint normal or nearly normal. No clear Tinel' sign, no clear presence of neuroma.

Case summary:

Superficial peroneal nerve entrapment in the AL portal after ankle arthroscopy

Question(s) to this case:

what is the best management for this case? Other exams are useful ?
GABA-pentin and group B vitamin are useful?



you mention nerve entrapment. Is there hypoaesthesia? Is there recognisable irradiating pain over the nerve at the portal side?

There is not hypoaesthesia, but pain irradiating trough the portal rising the leg. Pain is not at rest, but after more or less 30 minutes walking

If there is no hypoaesthesis then it must be considered as a local nerve irritation or just scar tissue at the portalside irritating the nerve. It will subside over time.
Let me know how it is 1 year after the surgery.
If there is to much pain then a small amount of local corticisteroid can be performed(0.1 cc)