Causes
There are several causes of peroneal paresis. A frequent cause is a so-called iatrogenic damage to the peroneal nerve. This means that the nerve has been damaged by medical action (for example during an operation) and the cause of the paresis is therefore indirectly attributable to the doctor.
Another cause of peroneal paresis can be an accident (trauma), for example a traffic accident in which the patient injures his knee or thigh. In this case, damage to fat and muscle tissue (soft tissue damage) can lead to an increase in pressure on the nerves, which in turn can damage them. Bleeding can also lead to increased pressure on the nerve, resulting in (temporary) peroneal paresis.
Furthermore, a fracture in the fibula or a dislocation of this bone (luxation) can be a cause of peroneus paresis, although this does not always have to occur. Another possible cause of peroneal paresis is a plaster cast that is too tight.This can press on the nerve from the outside and cause it to be damaged. Only in rare cases is a tumor responsible for a narrowing of the nerve, which is then considered the cause of peroneal paresis.
Another cause of peroneus paresis can be a herniated disc in the lumbar spine, whereby not only the peroneal nerve but also other nerves are usually affected. Therefore the symptoms are much more general and the symptoms of failure refer to larger areas. In rare cases, peroneus paresis may occur after hip surgery.
This is especially the case if there were unforeseen complications during hip surgery that lead to irritation or injury of the peroneal or sciatic nerve. The probability of peroneal paresis after hip surgery is very low, but due to the special location of the nerve, the physician may inadvertently damage the nerve. Often the peroneal paralysis after hip surgery is only temporary and can be corrected with physiotherapy and targeted training.
However, there are also cases in which the peroneal paralysis after hip surgery is permanent and thus causes permanent weakness in foot dorsiflexion. In general, the risk of peroneal paresis after hip surgery is very low, however, the attending physician should inform the patient of the risk, as any surgery can lead to unforeseen complications of which the patient should be aware. Peroneus paresis can always occur if the nerve in the lower leg has been damaged.
In most cases, the damage is unilateral, but peroneal paresis can occur on the right or left side. In this case, the peroneal paresis is particularly severe because the patient can no longer pull both feet up properly, which is why the so-called stork’s gait occurs. Peroneal paresis on the right and left side urgently requires intensive physiotherapy.
