Recurrent nontraumatic common peroneal neuropathy after surgical decompression: Case report and literature review.

RATIONALE: Common peroneal neuropathy (CPN) is a common peripheral neuropathy usually caused by trauma or prolonged compression. Nontraumatic and recurrent cases, however, are rare, especially in older adults. This report presents a case of recurrent nontraumatic CPN, emphasizing the diagnostic and therapeutic challenges.

PATIENT CONCERNS: A 69-year-old male presented with sudden right-sided foot drop, numbness, and paresthesia without recent trauma.

DIAGNOSES: Magnetic resonance imaging and electrodiagnostic studies confirmed nontraumatic CPN with compression near the fibular head.

INTERVENTIONS: The patient underwent surgical decompression and neurolysis of the common peroneal nerve, resulting in initial recovery. Two years later, symptom recurrence prompted re-evaluation, and a second decompression surgery was performed due to adhesions and scar tissue formation.

OUTCOMES: The patient achieved complete sensory and motor recovery within 3 months after the second surgery, with no postoperative complications.

LESSONS: Recurrent nontraumatic CPN may result from postoperative adhesions or incomplete decompression, particularly in older adults. Comprehensive diagnostic workup, including magnetic resonance imaging and electrodiagnostic studies, and extended decompression with careful follow-up are essential to prevent recurrence and ensure optimal recovery.