Introduction
Peroneus paresis is a paralysis of the nervus peroneus communis, also called nervus fibularis communis. This is a leg nerve that runs from the knee area to the foot and, together with other nerves, ensures that the lower leg is mobile. It also ensures the sensitivity of the patient in the area of the lower leg so that they can feel pain and touch the skin. The nervus peroneus communis is a branch of the nervus ischiadicus, which pulls out of the lumbar spine and then splits into different nerves at the thigh, such as the nervus peroneus communis.
Symptoms
Peroneal paresis causes specific symptoms, which are usually quite clear. Nevertheless, it is important to differentiate between whether the complete nerve peroneus communis no longer functions properly or whether one of its branches, i.e. the nerve peroneus superficialis or nerve peroneus profundus, is damaged.
- If only the nervus peroneus superficialis is affected, a numbness (sensitive deficit) occurs from the front of the lower leg over the back of the foot and along the first 4 toes, whereby the gap between the first and second toe can still be felt in the classic manner.
Although the lifting and lowering of the toes works, the patient is no longer able to tilt (pronate) the foot to the side.
- If, on the other hand, there is a loss of the nerve peroneus profundus, the patient also suffers from other symptoms. Classically, the patient can no longer lift the tip of the foot properly (dorsal extension). In general, the foot hangs down, which is why the patient has to pull the knees very high when walking so that the foot does not drag on the ground and the patient does not trip over it.
The resulting gait pattern is also called stepper gait or stork gait. In addition, the patient can no longer feel anything between the big toe and the second toe that he might notice when wearing a flip flop.
- If complete peroneal paresis occurs, in which both nerve parts are affected, the patient suffers from all the symptoms listed.
In peroneal paresis, in addition to a loss of various lower leg and foot muscles, there is always a loss of sensitivity. Depending on which of the two nerves is affected, however, these can feel very different.
If the peroneus profundus nerve is injured or irritated, peroneus paresis causes the patient to have sensitivity disorders between the big toe and the second toe, i.e. exactly in the area where a flip-flop is normally worn. If, on the other hand, the peroneus superfiscialis nerve is affected, the patient has sensitivity disorders on the front of the lower leg and on the back of the foot as a result of peroneus paresis. If both nerves are affected, the patient has complete peroneal paresis with sensitivity disorders in the area of the lower leg, the back of the foot and in the area of the toe gap between the first and second toe. In general, the sensitivity disorders in peroneal paresis are disturbing, but not as serious as the fact that the patient is unable to lift the foot properly because the muscles can no longer be properly addressed by the nerve. This then leads to the typical stork gait, which is much more conspicuous than a sensitivity disorder caused by peroneus paresis between the first and second toe.
