Which nerve is most commonly injured during tibial lengthening, producing foot drop in the second month of distraction?

• A Tibial nerve
• B Common peroneal nerve ✓
• C Sural nerve
• D Saphenous nerve

Explanation

The common peroneal nerve is the most frequently affected nerve in tibial lengthening because it winds around the fibular neck, where it is fixed against bone and least tolerant of stretch. Progressive distraction produces traction neurapraxia manifesting as foot drop. Prophylactic decompression of the nerve around the fibular neck is recommended when significant lengthening or correction through the proximal tibia is planned. The tibial, sural and saphenous nerves are more lax and rarely symptomatic.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.