This narrative review covers the evaluation and management of common peroneal nerve (CPN) palsy — the most common compressive neuropathy of the lower extremity. It addresses anatomy, etiology, clinical presentation, electrodiagnostic workup, and the full treatment spectrum from conservative measures through surgical decompression, nerve grafting, and tendon transfer.
When a patient presents with acute foot drop — especially after prolonged leg crossing, recent weight loss, knee surgery, or positioning under anesthesia — localize the lesion clinically (fibular head tenderness, Tinel sign, SPN vs. DPN sensory pattern) and obtain baseline EMG/NCV; if severe conduction delay (>50%) or dense motor denervation is present, don't wait — surgical decompression is indicated rather than continuing conservative management.
This narrative review covers the evaluation and management of common peroneal nerve (CPN) palsy — the most common compressive neuropathy of the lower extremity. It addresses anatomy, etiology, clinical presentation, electrodiagnostic workup, and the full treatment spectrum from conservative measures through surgical decompression, nerve grafting, and tendon transfer.
When a patient presents with acute foot drop — especially after prolonged leg crossing, recent weight loss, knee surgery, or positioning under anesthesia — localize the lesion clinically (fibular head tenderness, Tinel sign, SPN vs. DPN sensory pattern) and obtain baseline EMG/NCV; if severe conduction delay (>50%) or dense motor denervation is present, don't wait — surgical decompression is indicated rather than continuing conservative management.