[Therapeutic concepts in neurologic damage following severe soft tissue and bone injuries of the distal lower leg and foot].

In less than 1% of the cases nervous lesions after severe lower leg lesions demand surgical treatment: Neurosurgical Clinic: 28 reconstructive interventions on the lower leg, however, 362 on the forearm in 15 years; Clinic of Accident Surgery: 264 severest lower leg- and foot-injuries, among them only two nervous lesions. The n. peronaeus is more frequently affected than the n. tibialis. Even if continuity of the nerve is maintained, endoneural bleeding and internal ruptures can lead to extensive axonal lesions. The kind of nervous lesion (neurapraxia, axonotmesia, neurotmesia) should be clarified during the first three months, if possible, since it determines the prognosis as well as the kind of operative treatment during the first six months.