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Predictive Reliability of the Phoenix Sign for the Outcome of common fibular (Peroneal) nerve Decompression Surgery

Open Journal of Orthopedics 2020年第9期10卷 234-240页

作者： Stephen L. Barrett Adam Khan Victoria Brown Erik Rosas Sequioa Du Casse Porscha Bailey US Neuropathy Centers Atlanta GA USA Kennesaw State University Kennesaw GA USA

A positive Phoenix sign occurs when a patient, with a suspected focal nerve entrapment of the common fibular (Peroneal) nerve (CFN) at the level of the fibular neck, demonstrates an improvement in dorsifexion after an... 详细信息

A positive Phoenix sign occurs when a patient, with a suspected focal nerve entrapment of the Common Fibular (Peroneal) Nerve (CFN) at the level of the fibular neck, demonstrates an improvement in dorsifexion after an ultrasound guided infiltration of a sub-anesthetic dose of lidocaine. Less than 5 cc’s of 1% or 2% lidocaine is utilized and the effect is seen within minutes after the infiltration, but usually lasts only 10 minutes. This effect may be due to the vasodilatory action of lidocaine on the microcirculation in the area of infiltration. This nerve block has significant diagnostic utility as it is highly specific in the confirmation of true focal entrapment of the CFN, has high predictive value for a patient who may undergo surgical nerve decompression if they have demonstrated a positive Phoenix Sign, and may help in the surgical decision-making process in patients who have had a drop foot for many years but still may regain some motor function after decompression. In this retrospective review, 26 patients were tested, and 25 of this cohort demonstrated a Positive Phoenix Sign (an increase in dorsiflexion strength of the Extensor Hallucis Longus muscle (EHL)). One patient had no response to the peripheral nerve block. Of the 25 patients who demonstrated a positive “Phoenix Sign” and underwent nerve decompression of the CFN, and 25 (100%) showed an increase in dorsiflexion strength of the EHL after nerve decompression surgery of the CFN. The one patient in this cohort who did not dem

关键词： Peripheral nerve Block Drop Foot Ultrasound Guidance common Peroneal nerve entrapment common fibular nerve entrapment

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