Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Sural Nerve Fibrosis

Discussion in 'Foot Surgery' started by drsarbes, Mar 25, 2013.

  1. drsarbes

    drsarbes Well-Known Member


    Members do not see these Ads. Sign Up.
    Interesting case from last week.

    30 year old female with a history of receiving a cortisone injection approximately 3 -4 years ago for lateral ankle pain.

    She stated that when she received the injection it was "intensely painful" however the doctor continued to inject.

    She had a small ecchymotic area for several weeks where the injection was given, pain, and felt that even years later she could see a small purple discoloration.

    Symptoms have changed over the years finalizing in a constant burning, at times radiating pain along the outside of the left ankle / foot. Her original problem (ankle pain) had subsided. She feels her pain is directly related to the injection.

    We have treated her for the past 14 months with local Marcaine injections, lidoderm patches and pain medication with some success.

    An MRI showed a thickening of the Sural Nerve at the level of the distal fibular head.

    It was decided to surgically explore the area with a neurectomy as a possible procedure in order to alleviate her chronic nerve pain..

    Here are the photos. It appeared a perineurofibrosis had encompassed the Sural N.
    This was tediously debrided. We have not seen her postoperatively as yet.
     

    Attached Files:

  2. dazzalyn1

    dazzalyn1 Member

    Hello drsarbes,
    Lovely clear photos but not being a surgeon I'm assuming they are before and after pictures. I would love to have read a description of the process and some interim photos, no wonder it was so time consuming. I hope your patient recovers well and appreciates the skill needed for such a delicate procedure, thank you for posting it.
     
  3. drsarbes

    drsarbes Well-Known Member

    Hi Dazzalyn
    I appreciate your kind words, don't lay it on too thick, I already have a large ego.

    I did see the patient one week post op and so far so good. None of her pre-op pain and only surgical discomfort.

    I am somewhat optimistic.

    Steve
     
  4. Mart

    Mart Well-Known Member

    Hi Steve

    If you are still active in forum I am curious for hearing about outcome and further thought s in this case.

    I have a similar and difficult case currently and would be interested to discuss if there's anyone out there with some experiences to share.

    TIA Martin
     
Loading...

Share This Page