To test for the motor involvement of the superficial peroneal nerve and deep peroneal nerve, one must assess foot eversion (SPN) and foot/toe dorsiflexion (DPN). Terzis JK, Kostas I. Outcomes with microsurgery of common peroneal nerve lesions. The peroneal is one of the major nerves in your leg, and the most common injury symptom is weakness when raising your toes. When your peroneal nerve is injured, you may experience symptoms including: To prevent further damage to the peroneal nerve, padding, knee braces and splints can help restrict movement and encourage healing. Paralysie du nerf fibulaire commun: Diagnostic rare chez lenfant dun kyste synovial tibio-fibulaire suprieur. A person can take a few precautions to prevent peroneal tendonitis. View the article PDF and any associated supplements and figures for a period of 48 hours. For starters, talk to your doctor in case you have underlying issues. KwWf/-^T8s4tBc^;G One unusual etiology of SPN entrapment was reported in a patient with a distal fibular fracture following a closed reduction.61 The nerve became trapped within the bony fragments of the fracture site during reduction, which required surgical decompression of the nerve and internal fixation of the fracture.61, Fewer case reports are detailing DPN entrapment, with a total of three identified. Poage C, Roth C, Scott B. Peroneal Nerve Palsy. This nerve is quite exposed to trauma where it runs just under the skin on the outer side of the knee. Martin D, Dowling J, Rowan F, Casey M, OGrady P. Superficial peroneal nerve paresis in a dancer caused by a midfoot ganglion: case report. So, what can you do? Exercises However, an EMG examining other L4 to L5 and sciatic muscles can be tested in addition to differentiating a CPN mononeuropathy from sciatic neuropathy, lumbosacral plexopathy, and lumbar radiculopathy.23, For cases without a clear etiology, ultrasound offers a less expensive and non-invasive option to guide treatment. Sciatic nerve entrapment occurs anterior to the piriformis muscle or posterior to the gemelli-obturator internus complex, which is in line with the anatomical location of the ischial tuberosity. Step 3: Raise your heel, keeping the ankle straight and resisting the pressure to invert the foot as it comes off the floor. Morimoto D, Isu T, Kim K, et al. As the most common compressive neuropathy of the lower extremity, peroneal neuropathy, also known as fibular neuropathy, is a consideration for any differential diagnosis involving foot drop, the pain of the lower extremity, or numbness of the lower extremity.1 Commonly, it affects athletes and may hinder athletic performance.2 Peroneal neuropathy also affects the quality of life for those in occupations requiring significant squatting or kneeling.3 Understanding the origin, prevalence, and causes of peroneal neuropathy is imperative to holistic care for all patients experiencing lower extremity pain or weakness. The peroneal nerve is the nerve that communicates to the muscles that lift the foot. A Rare Case of Tibioperoneal Arterial Trunk Entrapment Caused by a Fibular Osteochondroma. Peroneal tendonitis may occur as a result of injury or damage to one or both peroneal tendons in the leg. Try to divide the weight evenly between your feet. Step back into a split stance, keeping both feet flat on the ground with the toes pointing forward. An EMG should examine at least the tibialis anterior, peroneus longus, and biceps femoris. By doing this too early or taking on too much too quickly, a person may further damage their peroneal tendons. All rights reserved. Garg B. Peroneal Nerve Palsy: Evaluation and Management. 0000004963 00000 n
Bouche P. Compression and entrapment neuropathies. World class care is in your backyard. If youre using a resistance band, you can perform repetitions of this exercise in a way thats similar to the exercises above. Eversion exercises strengthen the peroneus longus and can help with peroneal tendinopathies. Al oJ39.cp}gY7%X`gW
O Best stretches and exercises for plantar fasciitis and heel pain, Everything you need to know about plantar flexion, regularly stretching the calf, ankle, and peroneal muscles, wearing footwear that appropriately supports the foot, maintaining proper form when doing exercises that involve the calf, ankle, or peroneal muscles, increasing the intensity of any weight-bearing exercises, such as running, walking, or jogging, gradually. As you raise your heel, keep your knee over your ankle and your ankle straight and steady, and push down with your foot. Gkku K, Atmaca H, Sata E, Saylik M, Aydin AT. Place a quarter under the first metatarsal, the bone under your big toe, of one foot. Inspira Peroneal Nerve Entrapment Specialists, Multidisciplinary Approach to Peroneal Nerve Entrapment, Copyright @ 2023. As the most common compressive neuropathy of the lower extremity, peroneal neuropathy, also known as fibular neuropathy, is a consideration for any differential diagnosis involving foot drop, the pain of the lower extremity, or numbness of the lower extremity. Acute bilateral drop foot as a complication of prolonged squatting due to haemorrhoid. Park JH, Park KR, Yang J, Park GH, Cho J. Injuries related to the peroneus longus include peroneal tendonitis, ankle sprain, muscle strain, tendon dislocation (subluxation), and a painful condition called os peroneum syndrome. Contralateral comparison is often helpful in determining injury.24. Microsurgical decompression for peroneal nerve entrapment neuropathy. (2020). Park SH, Do HK, Jo GY. Our state-of-the-art surgical facilities are equipped with advanced 3D imaging technology, which allows our neurosurgeons to use minimally invasive techniques that reduce pain and scarring, improve surgicaloutcomesand speed up recovery time. Additional blocks can Step 1: Stand behind a chair. The common peroneal nerve (also called the common fibular nerve) is one of the two major nerves in your lower leg. Milants C, Wang FC, Gomulinski L, et al. Treating it depends on the underlying cause, but it can include physiotherapy or surgery. Thanks to Inspiras integrated provider network, our neurosurgical team is poised to provide personalized, coordinated care. In a practice involving large groups of athletes, seven runners and one soccer player with peroneal nerve compression neuropathy secondary to exercise have been found. Compression of the peroneal nerve in the leg. A common target for SPN lead placement is in the distal leg, just proximal to the lateral malleolus. Osteochondromas originating from unusual locations complicating orthopedic discipline: Case series. To perform this stretch, a person will require a bath or pool towel. 0000004278 00000 n
Most people can safely perform the following exercises at home with minimal extra equipment: This exercise can be done anywhere. Intra-articular Injections of the Ankle and Foot - Springer These initial non-invasive treatment options include lifestyle modification and changes in activities that trigger neuropathy.19, The most common and effective nonsurgical treatment options for CPN have been physical therapy maneuvers with nerve gliding and nerve flossing.21 Padding of the fibular head is another indirect trauma injury option and can work at night to prevent compression while sleeping.19, Management of an SPN palsy should be tailored to the etiology. An injection of anesthetic to the area of suspicion with relief of symptoms can confirm a suspected diagnosis.25, Radiographic imaging is important for diagnosing DPN neuropathy specifically as the most common causes are secondary to nerve impingement by osteophytes and trauma.17 Furthermore, symptoms of DPN neuropathy may be evoked with forced plantar or dorsiflexion and/or a positive Tinel sign over the site of entrapment. This nerve and its branches provide sensation to the tops of your feet and the fronts and sides of your legs. What's to know about peroneal tendonitis? Bonfiglioli R, Mattioli S, Violante FS. WebPhysical diagnosis for entrapment of the superficial peroneal nerve at the site of the peroneal tunnel was entertained based on clinical examination and three positive provocation tests. The nerve wraps from the back of the knee to the front of the shin and sits closely to the surface, making it easy to damage. There were no reported postoperative complications or symptom recurrence during the mean postoperative follow-up period of 40 months.28, The superficial course of the SPN <1 cm deep to the dermis makes it particularly susceptible to injury and compression; nonetheless, it also makes it a candidate for peripheral nerve stimulation (PNS).29 Consequently, percutaneous PNS is an alternative minimally invasive treatment method for certain pain manifestations of peroneal neuropathy. Please speak with your health care provider if you have a health concern or if you are considering adopting any exercise program or dietary guidelines. Step 1: Stand behind a chair. Bregman PJ, Schuenke M. Current Diagnosis and Treatment of Superficial Fibular Nerve Injuries and Entrapment. The most common entrapment neuropathy in the lower extremity is common peroneal mononeuropathy, accounting for approximately 15% of all mononeuropathies in adults [].Most injuries occur at the fibular head and can be the result of many factors including chronic low grade infection [], varicose veins [], schwannoma [], nerve What Causes a Pinched Nerve in Your Foot and How Can You Treat It? Wisner K, et al. Step 1: Using the back of a chair for balance, lift one foot off the ground, keeping the other foot level and the ankle steady. They reported the incidence of common peroneal nerve injury and dysfunction after total knee arthroplasty (TKA) is 0.4 % and found that 66% of cases with incomplete CPNP after TKA went on to complete recovery without surgical intervention. Learn more about our online scheduling and schedule an appointment with your primary care provider today. ^"Tis2Od3f8`hU( ?(:o=EviwT9Py8NwO{sO,Lx+em,.\f/ Dorsiflexion is when you move your toes up toward your shin. Common Peroneal Nerve Injury and Recovery after Total Knee Arthroplasty: A Systematic Review. Sciatica is a sensation in which you feel a moderate to intense pain in your back, buttocks, and legs. Lezak B, et al. You can learn more about how we ensure our content is accurate and current by reading our. However, weakness with foot eversion will likely be present.1 Decreased or abnormal sensation in the lower lateral leg, and the dorsum of the foot indicates involvement of the SPN or the portion of the sciatic nerve in those areas.20 Alternatively, there may be burning pain at the anterolateral leg and dorsum of the foot, with pressure at the entrapment point eliciting retrograde pain. The peroneal tendon can become damaged or injured due to sudden contraction. stream
They reported incomplete recovery in about 55% of people. WebMD does not provide medical advice, diagnosis or treatment. Your next step is to look for and massage the tender points in your peroneus longus muscle. 0q59Dd,&S9x Recurrent stretch and inversion injuries and repetitive ankle sprains or even soft masses, like ganglia, may also induce compression nerve injury of the SPN.16 SPN mononeuropathy may also occur secondary to direct trauma, fibular fracture, tight-fitting legwear, fascial defects, or muscle herniation.17, Anterior Tarsal Tunnel Syndrome (ATTS) is the specific name for the uncommon pathology of the DPN. It could take longer if the bone broke your skin. 3. <>
PERONEAL NERVE ENTRAPMENT 0000006352 00000 n
In: Bowley MP, Doughty CT. Entrapment Neuropathies of the Lower Extremity. Letting go of the support, lower the heels down slowly. The standing calf stretch requires a sturdy closed door or a blank wall. Lower extremity nerve entrapments in athletes. Knee or leg fracture. Hobson-Webb LD, Juel VC. To help regain strength in the peroneal muscles and aid recovery from peroneal tendonitis, a person may consider doing exercises and stretches that target the affected area and surrounding muscles. Carender CN, et al. Exercises to Strengthen the Peroneus Longus. 0000007439 00000 n
2023 Lineage Medical, Inc. All rights reserved, Foot & AnkleDeep Peroneal Nerve Entrapment. Doctors, physiotherapists, and other healthcare professionals begin the diagnostic process by performing a physical exam and examining your medical history. After the resting phase of recovery, exercises that work the peroneal muscles may help improve and strengthen the area. The common peroneal nerve is most vulnerable where it wraps around the top of your fibula. <]/Prev 365257/XRefStm 1430>>
Cruz-Martinez A, Arpa J, Palau F. Peroneal neuropathy after weight loss. Puffer RC, Sabbag OD, Logli AL, Spinner RJ, Rose PS. Return to the starting position. Hold the stretch for 15 to 30 seconds. The diagnosis is often made with physical exam findings of decreased strength, altered sensation, and gait abnormalities. O5S?X!d0^AmM]}0_dcnQ@e,Sk"Q!T+;
`q;N'R--SWS e[vn>lM~ ysaRmT{-wiRnUKLfe;iZTN"?l/`#>^$A6gvQQ\`aoQT- {gDl9~NOQ
PkvHr{>=>sc8Z@wFR L&d}amxI-Xi0WM5n9] ( JJ Ti
,;? The common fibular (peroneal) nerve (CFN) is the most frequent nerve entrapment of the lower extremity [3, 6, 25, 38].This nerve contains motor and sensory fibers, and its entrapment can cause sensory-related pain in the leg, ankle, and foot, which may be described as pain, numbness, burning, and/or tingling; it can also cause Slowly lift your leg so your knee goes straight. Anderson JC. While entrapment neuropathies are relatively uncommon in the lower extremities, peroneal nerve entrapment is the most frequently encountered lower limb neuropathy.1,65 Due to the relative infrequency of lower limb neuropathies, diagnosis can be difficult and often overlooked.65 Providers must have a level of suspicion when patients present with chronic leg pain, foot drop, or ankle instability that has not responded to conservative medical management.65 Peroneal nerve entrapment is most commonly at or around the fibular head but can also occur in the calf, ankle, or foot.1 Electrodiagnostic studies have shown to be helpful in the diagnosis of nerve entrapment and in determining the type of injury and the level at which the entrapment occurs.1 First-line treatment usually includes removing anything that may be causing external compression, providing stability to any unstable joints that may be putting tension on the nerve, and reducing inflammation.65 Although many peroneal nerve entrapments will resolve with less invasive treatment. Poage C, Roth C, Scott B. Peroneal Nerve Palsy: Evaluation and Management. We also explain how to prevent the condition and list some exercises that a person can try. Occupational mononeuropathies in industry. Repeat the movement up to 10 times. A person may require physical therapy to help restore function and movement to the affected area. Exercises to help relieve peroneal tendonitis All rights reserved. At the same time, 7 also reported full recovery of motor function at 12 months postoperatively.32 A retrospective review of a prospective database of patients with CPN palsy due to various etiologies showed clinical improvement in 28 of 30 patients who underwent neuroplasty and decompression.33 Another study that reviewed subjects with CPN compression and foot drop secondary to weight loss showed an 85% success rate in patients receiving external neurolysis at the fibular head.34 A recent retrospective analysis of 35 patients undergoing microneurolysis and nerve decompression resulted in only 1 poor outcome, indicated by the inability to dorsiflex the ankle to 90 degrees.35 Overall, surgical decompression effectively treats CPN entrapment, with some studies showing a positive correlation between decreased time to surgery and improved outcomes.32, SPN entrapment is less common than CPN entrapment, and studies show that most patients who undergo decompressive surgery for SPN entrapment have previously undergone surgery for CPN entrapment.36 SPN entrapment is a commonly missed diagnosis; therefore, surgeons working distally to the knee must be aware of the technical maneuvers and be familiar with the anatomy of the peripheral nerves in the lower extremity.37 Decompression of the SPN is performed where the nerve exits the lateral compartment and should extend to include its terminal nerve branches.2,38, A small study of 5 patients, previously treated with surgical decompression of CPN entrapment, all showed improvement of symptoms immediately after SPN surgical decompression.36 Of these 5 patients, entrapment symptoms recurred in one patient who required additional complete nerve decompression with no further return of symptoms.36 A more extensive study of 54 patients undergoing SPN decompression showed 69% of subjects reported some improvement in the effect of pain on quality of life, with a positive correlation between pain severity and improvement with surgery.39 An additional study reported an 85% success rate with SPN nerve decompression.38 The authors note that failure of surgical decompression in those with chronic nerve pain may be secondary to the centralization of pain over time.38 In these cases, pain management specialists and biopsychologists are recommended to improve the success of surgical decompression.38, Compression of the DPN, known as ATTS, can be surgically treated with either an open or arthroscopic approach.40 Surgical approach involves an incision in the dorsum of the foot and releasing the nerve from the inferior extensor retinaculum to its entry into the deep fascia. If this self-treatment helped, but not totally, you can: Im curious, have you had any tingling or numbness after an activity you love? Meadows JR, Finnoff JT. By reviewing Pull your knee in towards your chest. If these exercises produce excessive pain or cause weakness, you should consult your doctor. After resting the area for a few days, if the inflammation has subsided, a person may consider performing gentle stretches and exercises to help strengthen the area. endobj
Compression of the peroneal nerve by a Peroneal Nerve Peroneal Nerve Injury 0000001774 00000 n
Progress through the following steps, stopping once tension is felt in the foot/leg. Pediatric peroneal mononeuropathy: A clinical and electromyographic study. Peroneal nerve injury. The precise site of compression can also be located by a nerve block of the affected area.25, Treatment of peroneal nerve injuries varies based on the etiology and severity of symptoms. It can cause pain that radiates from the ankle to the outside of the foot. zGr(_EJgYtV8+JgYtV8+Jge1K*
4`\TYl!1L{whb[ ?
Symptoms may initially be masked by concomitant trauma or recovery from surgical procedures. In: Moatshe G, Dornan GJ, Lken S, Ludvigsen TC, Laprade RF, Engebretsen L. Demographics and injuries associated with knee dislocation: A prospective review of 303 patients. Carender CN, Bedard NA, An Q, Brown TS. Physical Exercise for Peroneal Nerve Dysfunction Idusuyi OB, Morrey BF. Achilles stretch: Stand with the ball of one foot on a stair. 0000007854 00000 n
The clinical presentation of peroneal neuropathy varies depending on the location of nerve injury or compression. Let's look at your options: Learn all about pudendal nerve entrapment, including symptoms, complications, treatment, and helpful exercises. A physical exam analyzing strength, sensation, and gait can localize the specific nerves affected. anterior leg/ankle/foot from 1 cm proximal to ankle joint proximally to talonavicular joint distally, ankle inversion and plantar flexion (when traumatic), dorsal osteophytes over tibiotalar or talonavicular joints, other bony deformity (pes cavus, post-fracture), tendinitis or hypertrophic muscle belly of EHL, EDL or TA, trauma (including recurrent ankle instability), systemic conditions causing peripheral edema, dysesthesia and paresthesias on dorsal foot, lateral hallux, medial second toe and first web space are most common locations, Tinel sign over course of DPN with possible radiation to first web space, exacerbation with plantar flexion and inversion (puts nerve on stretch), relief of symptoms with injection of lidocaine (DPN nerve block), night splint (to prevent natural tendency for ankle to assume plantar flexion), diuretic if chronic peripheral edema is implicated, symptoms of RSD are a contraindication to release, S-shaped incision over dorsum of foot from ankle joint proximally to base of first and second metatarsals distally, start distal, identify nerve, and release both branches proximally (nerve lies lateral to EHL), resect osteophytes, debulk hypertrophic muscle bellies, Persistent symptoms following decompression, Recalcitrant cases may require surgery, which may yield 80% good to excellent results, Posterior Tibial Tendon Insufficiency (PTTI). Rise onto the toes and hold the position for 510 seconds. 0000079156 00000 n
Read on to discover stretches that can help relax tight calf muscles. Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study. Dhinsa BS, Hussain L, Singh S. The management of dorsal peroneal nerve compression in the midfoot. Corticosteroid injections may also reduce swelling and relieve pressure on the nerve. Roll the foot back and forth over the object for 1 minute. Decompression of the superficial peroneal nerve: Clinical outcomes and anatomical study. An Update on Peroneal Nerve Entrapment and Neuropathy. Sign Up to Get Ridiculously Practical Tips in Your Inbox. Experiment with different angles. See additional information. Terry felt a burning sensation on the top of his left foot, down to his big toe. @SoIUOSu]RB-B+5JG_/aFAFaFAFy~f^A^a^A^a^A^aT-[XXXXXXXX2X0XfhoW+J_SEJEsAg 0000004787 00000 n
Koksal A, Dogan VB. Clinical presentation of CPN neuropathy includes weakness of ankle dorsiflexion, great toe extension, foot eversion, and sensory loss to the dorsum of the foot. w ~hFF3wzf-hs.|64Ptrf-/*jLpW\7#\3k7 TVv(|?R204'[rt"D>e3L Izwgq ?E&R:iB8*$ IT8o|{BU2UC21a($Ayya2cssZ $%M w[O#otU&tvsYr_NV9z8'f"nqQ3DjY"gu*#: In these cases, DPN entrapment was due to ganglion cysts in 2 cases and bony overgrowth of the navicular bone in 1 case.6264 One of the ganglion cysts was treated with CT-guided fenestration, pulsed radiofrequency modulation, and steroid injection into the cyst. Modifications: As with the quarter heel raise, you can perform this exercise on both feet at once or in a seated position. Sitting upright on the floor, place the resistance band around the ball of one foot and then extend that leg out in front. Start each exercise slowly. Peroneal neuropathy is the most common compressive neuropathy of the lower extremity. 2023 Healthline Media LLC. Slowly lean forward and bend the front knee to feel a stretch in the lower part of the back leg. 1. Aside from the clinical presentation of CPN neuropathy described in the previous section, the diagnosis may be aided by eliciting a Tinels sign or performing a diagnostic nerve block.22 Motor nerve conduction studies are another helpful tool for diagnosis for localization. I tend to think of nerve entrapment when I hear stories like this. Last medically reviewed on September 22, 2020, Doctors perform tendon repair surgery to fix a tendon injury. Peripheral Nerve Stimulation for the 21st Century: Sural, Superficial Peroneal, and Tibial Nerves. An Update on Peroneal Nerve Entrapment and Neuropathy. You can also perform this exercise seated with one foot on the floor. The main functions of this treatment are to release soft tissue adhesions that cause entrapment and restore the nerves function. Tzika M, Paraskevas G, Natsis K. Entrapment of the superficial peroneal nerve: An anatomical insight. 0000018245 00000 n
0000051947 00000 n
nerve Lower extremity nerve injury in childbirth. The most common symptom of peroneal nerve injury is foot drop, which is weakness in your ability to dorsiflex your ankle. Diagnosis 0000026719 00000 n
They may order imaging tests to help find the source of your symptoms such as: They may also order tests to evaluate your nerve function such as: Peroneal nerve injury is a potential risk of knee replacement surgery. The issue appears during or right after a specific activity and is described as tingling, numbness or a burning sensation. x@ l;B
How to do the exercises Calf wall stretch (back knee straight) 1. SPN mononeuropathy is a relatively rare phenomenon.16 Symptoms may present similarly to CPN neuropathy, lateral leg compartment entrapment syndrome, or L5 radiculopathy, so it is important to rule these pathologies out before making a definite diagnosis. Sorry, something went wrong. Common peroneal nerve injury and recovery after total knee arthroplasty: A systematic review. Tightness in the calf muscles can be uncomfortable and even painful. WebThe peroneal nerve can be injured by trauma and nerve compression, including: Knee dislocation. ncbi.nlm.nih.gov/pmc/articles/PMC7451888/, ncbi.nlm.nih.gov/pmc/articles/PMC9702062/, orthoinfo.aaos.org/en/diseases--conditions/tibia-shinbone-shaft-fractures, journals.lww.com/mcnjournal/Citation/2021/05000/Lower_Extremity_Nerve_Injury_in_Childbirth.9.aspx. 0000037830 00000 n
The CPN is most commonly compressed by the bony prominence of the fibula, the SPN most commonly entrapped as it exits the lateral compartment of the leg, and the DPN as it crosses underneath the extensor retinaculum. (n.d.). How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Benefits of exercises for peroneal tendonitis, https://www.acefitness.org/education-and-resources/lifestyle/exercise-library/23/ankle-flexion/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161709/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/, https://www.foothealthfacts.org/conditions/peroneal-tendon-injuries, https://www.acefitness.org/education-and-resources/lifestyle/exercise-library/152/standing-dorsi-flexion-calf-stretch/, https://www.ncbi.nlm.nih.gov/books/NBK544354/, New clues to slow aging? Surgical Results of Common Peroneal Nerve Neuroplasty at Lateral Fibular Neck. Souter J, Swong K, McCoyd M, Balasubramanian N, Nielsen M, Prabhu VC. About a third of cases of peroneal nerve injury not associated with an open wound heal by themselves. 0000032562 00000 n
Lower Nerve Flossing A finding of weakness of both foot eversion as well as foot/toe dorsiflexion suggests a lesion involving the common peroneal nerve. Your peroneus longus muscles help you move your ankles, flex your feet, and maintain your balance. WebPeripheral nerve entrapment occurs when a nerve passes through a narrow anatomic tunnel or when a nerve becomes edematous. Peroneal nerve palsy after total knee arthroplasty: Assessment of predisposing and prognostic factors. The two peroneal tendons run side by side behind the outer ankle bone. WebAbstract. Healthline Media does not provide medical advice, diagnosis, or treatment. What increases your risk of a peroneal nerve injury? Brestas P, Protopsaltis I, Drossos C. Role of sonography in the diagnosis and treatment of a ganglion cyst compressing the lateral branch of deep peroneal nerve. Compressive peroneal neuropathy by an intraneural ganglion cyst combined with L5 radiculopathy: A case report. WebObturator Nerve Injury- Obturator nerve injury is rare and most of the injuries are observed following auto accident and sport injury. endstream
endobj
429 0 obj
<>
endobj
430 0 obj
<>
endobj
431 0 obj
<>stream