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10 pages, 3222 KiB

Open AccessCase Report

Palsy of Both the Tibial Nerve and Common Peroneal Nerve Caused by a Ganglion Cyst in the Popliteal Area

by Sang-Heon Lee, Sung-Hwan Kim, Ho-Sung Kim and Hyun-Uk Lee

Medicina 2024, 60(6), 876; https://doi.org/10.3390/medicina60060876 - 27 May 2024

Cited by 1 | Viewed by 2499

A ganglion cyst is a benign mass consisting of high-viscosity mucinous fluid. It can originate from the sheath of a tendon, peripheral nerve, or joint capsule. Compressive neuropathy caused by a ganglion cyst is rarely reported, with the majority of documented cases involving peroneal nerve palsy. To date, cases demonstrating both peroneal and tibial nerve palsies resulting from a ganglion cyst forming on a branch of the sciatic nerve have not been reported. In this paper, we present the case of a 74-year-old man visiting an outpatient clinic complaining of left-sided foot drop and sensory loss in the lower extremity, a lack of strength in his left leg, and a decrease in sensation in the leg for the past month without any history of trauma. Ankle dorsiflexion and great toe extension strength on the left side were Grade I. Ankle plantar flexion and great toe flexion were Grade II. We suspected peroneal and tibial nerve palsy and performed a screening ultrasound, which is inexpensive and rapid. In the operative field, several cysts were discovered, originating at the site where the sciatic nerve splits into peroneal and tibial nerves. After successful surgical decompression and a series of rehabilitation procedures, the patient’s neurological symptoms improved. There was no recurrence. Full article

(This article belongs to the Special Issue Update on Orthopedic Surgeries of the Lower Extremity Diseases and Injuries: 2nd Edition)

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9 pages, 3262 KiB

Open AccessArticle

Deep Learning-Based Knee MRI Classification for Common Peroneal Nerve Palsy with Foot Drop

by Kyung Min Chung, Hyunjae Yu, Jong-Ho Kim, Jae Jun Lee, Jong-Hee Sohn, Sang-Hwa Lee, Joo Hye Sung, Sang-Won Han, Jin Seo Yang and Chulho Kim

Biomedicines 2023, 11(12), 3171; https://doi.org/10.3390/biomedicines11123171 - 28 Nov 2023

Cited by 2 | Viewed by 2318

Abstract

Foot drop can have a variety of causes, including the common peroneal nerve (CPN) injuries, and is often difficult to diagnose. We aimed to develop a deep learning-based algorithm that can classify foot drop with CPN injury in patients with knee MRI axial images only. In this retrospective study, we included 945 MR image data from foot drop patients confirmed with CPN injury in electrophysiologic tests (n = 42), and 1341 MR image data with non-traumatic knee pain (n = 107). Data were split into training, validation, and test datasets using a 8:1:1 ratio. We used a convolution neural network-based algorithm (EfficientNet-B5, ResNet152, VGG19) for the classification between the CPN injury group and the others. Performance of each classification algorithm used the area under the receiver operating characteristic curve (AUC). In classifying CPN MR images and non-CPN MR images, EfficientNet-B5 had the highest performance (AUC = 0.946), followed by the ResNet152 and the VGG19 algorithms. On comparison of other performance metrics including precision, recall, accuracy, and F1 score, EfficientNet-B5 had the best performance of the three algorithms. In a saliency map, the EfficientNet-B5 algorithm focused on the nerve area to detect CPN injury. In conclusion, deep learning-based analysis of knee MR images can successfully differentiate CPN injury from other etiologies in patients with foot drop. Full article

(This article belongs to the Section Biomedical Engineering and Materials)

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8 pages, 3531 KiB

Open AccessCase Report

Development of a New Ankle Joint Hybrid Assistive Limb

by Shigeki Kubota, Hideki Kadone, Yukiyo Shimizu, Masao Koda, Hiroshi Noguchi, Hiroshi Takahashi, Hiroki Watanabe, Yasushi Hada, Yoshiyuki Sankai and Masashi Yamazaki

Medicina 2022, 58(3), 395; https://doi.org/10.3390/medicina58030395 - 7 Mar 2022

Cited by 12 | Viewed by 4817

Abstract

Foot and ankle disabilities (foot drop) due to common peroneal nerve palsy and stroke negatively affect patients’ ambulation and activities of daily living. We developed a novel robotics ankle hybrid assistive limb (HAL) for patients with foot drop due to common peroneal nerve palsy or stroke. The ankle HAL is a wearable exoskeleton-type robot that is used to train plantar and dorsiflexion and for voluntary assistive training of the ankle joint of patients with palsy using an actuator, which is placed on the lateral side of the ankle joint and detects bioelectrical signals from the tibialis anterior (TA) and gastrocnemius muscles. Voluntary ankle dorsiflexion training using the new ankle HAL was implemented in a patient with foot drop due to peroneal nerve palsy after lumbar surgery. The time required for ankle HAL training (from wearing to the end of training) was approximately 30 min per session. The muscle activities of the TA on the right were lower than those on the left before and after ankle HAL training. The electromyographic wave of muscle activities of the TA on the right was slightly clearer than that before ankle HAL training in the resting position immediately after ankle dorsiflexion. Voluntary ankle dorsiflexion training using the novel robotics ankle HAL was safe and had no adverse effect in a patient with foot drop due to peroneal nerve palsy. Full article

(This article belongs to the Topic Orthopaedic Diseases and Innovative Intervention Strategies)

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