Acute onset common peroneal nerve palsy in a child due to fibular head osteochondroma: a case report

Swapnil M. Keny; Lokesh Dabral; Prashant Meshram; Naved Ansari; Nikhil Gokhale; Shashikant Nawale; Abhishek Jaroli

doi:10.18203/issn.2455-4510.IntJResOrthop20220616

Authors

Swapnil M. Keny Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India
Lokesh Dabral Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India
Prashant Meshram Orthocure Medical Center, Dubai, UAE http://orcid.org/0000-0003-4537-5052
Naved Ansari Department of Orthopaedics, Grant Government Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India
Nikhil Gokhale Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India
Shashikant Nawale Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India
Abhishek Jaroli Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20220616

Keywords:

Acute, Common peroneal, Osteochondroma, Nerve palsy, Foot drop, Pediatric

Abstract

A 7-year-old patient presented with acute onset spontaneous common peroneal nerve (CPN) palsy due to osteochondroma of fibular head. Osteochondroma was excised resulting in complete neurological recovery. As per our knowledge, this is the first case of an acute onset CPN palsy in a child due to osteochondroma. 14 studies reporting patients with CPN palsy due to osteochondroma were analyzed. Of 24 patients reported with this condition in literature, 19 (79%) recovered completely from CPN palsy. Incomplete recovery after surgery was associated with a longer mean duration between symptoms and surgery (26 months versus 5 months for complete recovery).

Metrics

Metrics Loading ...

Author Biography

Prashant Meshram, Orthocure Medical Center, Dubai, UAE

ASSISTANT PROFESSOR IN DEPARTMENT OF ORTHOPAEDICS

References

Tong K, Liu H, Wang X. Osteochondroma: Review of 431 patients from one medical institution in South China. J Bone Oncol. 2017;8:23-29.

Bovée JV. Multiple osteochondromas. Orphanet J Rare Dis. 2008;3:3.

Dorfman HD, Mosby CB. St. Louis: 1998. Osteochondroma. Bone tumors. 1998;331-46.

Göçmen S, Topuz AK, Atabey C, Şimşek H, Keklikçi K, Rodop O. Peripheral nerve injuries due to osteochondromas: analysis of 20 cases and review of the literature. J Neurosurg. 2014;120(5):1105-12.

N.-J. Paik, T. R. Han, and S. J. Lim, “Multiple peripheral nerve compressions related to malignantly transformed hereditary multiple exostoses,” Muscle & Nerve. 2000;23(8):1290-4.

Cardelia JM, Dormans JP, Drummond DS, Davidson RS, Duhaime C, Sutton L. Proximal fibular osteochondroma with associated peroneal nerve palsy: a review of six cases. J Pediatr Orthop. 1995;15(5):574-7.

D. M. Dawson, M. Hallett, L. Millender, Entrapment Neuropathies, Little, Brown and Company, Boston, MA, USA, 2nd edition. 1990.

Arabi H, Bakzaza O, El Fikri A, Elktaibi A, Saidi H, El Alaoui M. Compression of the peroneal nerve by a neurofibroma originating from collaterals of the peroneal nerve: a case report. J Med Case Rep. 2016;10:28.

Cherrad T, Bennani M, Zejjari H, Louaste J, Amhajji L. Peroneal Nerve Palsy due to Bulky Osteochondroma from the Fibular Head: A Rare Case and Literature Review. Case Reports in Orthopedics. 2020;8825708.

Mnif H, Koubaa M, Zrig M, Zammel N, Abid A. Peroneal nerve palsy resulting from fibular head osteochondroma. Orthopedics. 2009;32(7):528.

Yoo JH, Min KD, Kim CK. A case of extension loss of great toe due to peroneal nerve compression by an osteochondroma of the proximal fibula. Arch Orthop Trauma Surg. 2010;130:1071-5.

Montella BJ, O'Farrell DA, Furr WS, Harrelson JM. Fibular osteochondroma presenting as chronic ankle sprain. Foot Ankle Int. 1995;16(4):207-9.

Çınar A, Yumrukçal F, Salduz A, Dirik Y, Eralp L. A rare cause of 'drop foot' in the pediatric age group: Proximal fibular osteochondroma a report of 5 cases. Int J Surg Case Rep. 2014;5(12):1068-71.

Flores LP, Koerbel A, Tatagiba M. Peroneal nerve compression resulting from fibular head osteophyte-like lesions. Surg Neurol. 2005;64(3):249-52.

Demiroğlu M, Özkan K, Kılıç B, Akçal A, Akkaya M, Özkan FÜ. Deep peroneal nerve palsy due to osteochondroma arising from fibular head and proximal lateral tibia. Int J Surg Case Rep. 2017;31:200-2.

Gökkuş K, Atmaca H, Sağtaş E, Saylik M, Aydin AT. Osteochondromas originating from unusual locations complicating orthopedic discipline: case series. Eklem Hastalik Cerrahisi. 2015;26(2):100-9.

Kim YJ, Lee JW, Chea SU, Yang JH. Case Report : A Case of Peroneal Nerve Palsy Secondary to Fibular Head Osteochondroma. Knee Surg Relat Res. 2011;23(1):47-50

Manoharan A, Suresh SS, Sankaranarayanan L. Proximal Fibular Osteochondroma Producing Common Peroneal Nerve Palsy in a Post-Cesarean Section Patient. Oman Med J. 2013;28(3):e047.

Paprottka FJ, Machens HG, Lohmeyer JA. Partially irreversible paresis of the deep peroneal nerve caused by osteocartilaginous exostosis of the fibula without affecting the tibialis anterior muscle. J Plast Reconstr Aesthet Surg. 2012;65(8):e223-5.

Watson LW, Torch MA. Peroneal nerve palsy secondary to compression from an osteochondroma. Orthopedics. 1993;16(6):707-10.

Gallagher-Oxner K, Bagley L, Dalinka MK, Kneeland JB. Case report 822: Osteochondroma causing peroneal palsy-imaging evaluation. Skeletal Radiol. 1994;23(1):71-2.

Manigoda M, Dujmović-Basuroski I, Trikić R, Drulović J. Acute sciatic neuropathy--"post-Saturday palsy. Srp Arh Celok Lek. 2005;133(1-2):58-61.

Marciniak C. Fibular (peroneal) neuropathy: electrodiagnostic features and clinical correlates. Phys Med Rehabil Clin N Am. 2013;24(1):121-37.

Lange RH, Lange TA, Rao BK. Correlative radiographic, scintigraphic, and histological evaluation of exostoses. J Bone Joint Surg Am. 1984;66(9):1454-9.

Ozden R, Uruc V, Kalacı A, Dogramacı Y. Compression of common peroneal nerve caused by an extraneural ganglion cyst mimicking intermittent claudication. J Brachial Plex Peripher Nerve Inj. 2013;8(1):5.