Foot Drop Recovery One Year Later

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.
We are now approximately one year from a decompression of the common peroneal nerve at the fibular head for a patient who had a foot drop. This foot drop, here’s his knee right here and the fibular head is right at this level and the common peroneal nerve comes right around this area here. The common peroneal nerve is responsible for the ability to lift the foot up as well as to bring the foot outward and upward, and to extend the toes.
 
He was not able to do that and it’s not clear what happened, but after approximately a year and a half of continual weakness, he had no back pain and no symptoms from his spine, which is a common cause, he’d never had an operation that suddenly caused this to occur, but sure enough over a year and a half he lost the function of the ability to raise his foot up. In the operating room, we were able to release this common peroneal nerve at the fibular head, and what was fairly exciting in his case was that within about five minutes after releasing that nerve, we were able to stimulate that foot with electricity and have it move up in the operating room. We’re now a year out and show us how you  move that foot. Up and down - the toes raise it up - great. 
How does that compare to the day before you met us?
 
I had pain and I could not lift  my foot.
 
You had mentioned that you had pain and some tingling that would come down your leg into the top of your foot, if I recall. Is that correct?
 
Yes. 
 
How has that responded as well?
 
Most of the pain is gone and the foot is functioning without a brace at this point.
 
Great. Now there is still some residual weakness in his foot, it’s not quite as strong as the other side, but this foot hadn’t been working for about a year and a half until we decompressed it, based on when he came to see us. Hopefully, with a little more directed exercise and a little more use of some bands and a few more months of strong exercise we’ll get that back. It’s about almost full strength but not quite. He does have a residual tingling in the top of his foot and at this time, we’ve diagnosed that one of those branches of the common peroneal nerve is actually stuck right about here, and it needs to continue to grow down the top of his foot, but there’s a place that it can get stuck, and this is where that occurs, where sometimes that needs to be opened up and released so the nerve can continue to grow downstream.
Overall, how has this affected your ability to walk on a regular day-to-day basis and the ability to sleep and be more comfortable?
 
It’s much, much better. I’m walking without the brace. I’m very pleased with it.
 
Very good. Thank you very much!