Distal posterolateral corner injury in the setting of multil
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The purpose of this study was to identify if the location of posterolateral corner (PLC) injury was predictive of clinical common peroneal nerve (CPN) palsy.

A retrospective chart review was conducted of patients presenting with operative PLC injuries. Assessment of concomitant injuries and presence of neurologic injury was completed via chart review and magnetic resonance imaging (MRI) review. A fellowship-trained musculoskeletal radiologist reviewed the PLC injury and categorized it into distal, middle and proximal injuries with or without a biceps femoral avulsion. The CPN was evaluated for signs of displacement or neuritis.

47 operatively managed patients (mean age-at-injury 29.5±10.7 years) were included in this study. 11 total patients presented with a clinical CPN palsy.

--Distal PLC injuries were significantly associated with CPN palsy [9 patients]. 9 of 11 patients with CPN palsy had biceps femoral avulsion. Of the patients presenting with CPN palsy, only 4 patients experienced complete neurologic recovery.

--3/7 patients with an intact CPN had full resolution of their clinically complete CPN palsy at the time of follow-up (482±357 days).

--All patients presenting with a CPN palsy also had a complete anterior cruciate ligament (ACL) rupture in addition to a PLC injury, with or without a posterior cruciate ligament (PCL) injury.

--No patient presenting with an isolated pattern of PCL-PLC injury (those without ACL tears) had a clinical CPN palsy.

Conclusively, in the initial post-operative period, Distal PLC injuries have a strong association with clinical CPN palsy, with suboptimal resolution. In particular, the occurrence of injury to biceps femoris avulsion was closely associated with clinical CPN palsy. Additionally, CPN palsy has a strong correlation with concomitant ACL injury in the sense of PLC injury. In addition, the relative rates of ACL vs. PCL involvement indicate that particular injury mechanisms can play an important role in CPN palsy.

Source: https://link.springer.com/article/10.1007/s00167-021-06469-z