The Sequelae of Drop Foot After Knee Dislocation: Evaluation and Treatment

Although knee dislocations are relatively rare, serious complications make treatment difficult. Common peroneal nerve (CPN) palsy is a debilitating complication with an incidence reported as high as 50%. Even after successful ligament reconstruction or repair, unresolved CPN palsy is a major factor contributing to poor outcomes. CPN palsy is more common with open dislocations, rotatory dislocations, and in patients with posterolateral corner injuries. CPN palsy can be readily diagnosed clinically, although a high index of suspicion is needed. Conservative management can be appropriate in the early phase of treatment; however, for persistent nerve damage, surgery is the treatment of choice because it results in better functional outcomes. The benefits of surgical exploration in the acute setting are controversial. Neurolysis, primary nerve repair, nerve grafting, and posterior tibialis tendon transfer have all been used as surgical options. As late surgical treatment of CPN typically results in poor prognosis, prompt diagnosis and close follow-up are of paramount importance.