Osteochondroma arising from head of the fibula: a rare cause
The common peroneal nerve (CPN) or external popliteal nerve is the most frequently involved nerve in entrapment syndromes in the lower extremities. Its proximity to the head of the fibula makes it particularly susceptible to damage by different injury mechanisms. Osteochondromas arising from the proximal fibula are a rare cause of common peroneal nerve injury.

Published in the International Journal of Paediatric Orthopaedics, the authors report a case of a 13-year-old Caucasian male patient referred to our hospital with drop foot and palpable mass in the head of the right fibula. Physical examination revealed a severe paresis, grade 2 objectified by the scale of the Medical Research Council (MRC) in the extensor hallucislongus, extensor digitorumlongus and tibialis anterior muscles and hypoesthesia in the dorsal surface of foot and portions of the anterior, lower-lateral leg.

In MRI a tumor in the head of the fibula compressing the CPN is observed. Electromyographic studies confirmed the presence of severe partial axonotmesis of the right peroneal nerve. The patient underwent surgery for decompression of the peroneal nerve and resection of the proximal fibula osteocartilaginousexostosis.

The histopathological analysis confirmed the diagnosis of osteochondroma. At the 12-month postoperative follow-up the patient recovered sensitivity and presented, according to the MRC scale, muscle strength of 4 out of 5 in the previously named muscles, being able to walk without orthotic devices. In the electromyography, subacute axonotmesis with important signs of active reinnervation observed.

Read in detail here: http://ijpoonline.com/wp-content/uploads/2018/06/7.Art-41-final.pdf