Nerve conduction study Nerve Amplitude (mV-[mu]V) Latency (msec) Median motor 11 2.7 Median sensory 13 3.1 Ulnar motor 7.5 2.2 Ulnar sensory 15 2.6 Posterior tibial motor 5 4.1 Sural sensory 11 3.4 Peroneal sensory No response Peroneal mixed No response Peroneal motor ankle/above the head of fibula/ 0.4/0.4/0.3 3.5 (ankle) below the head of fibula
Nerve Nerve conduction velocity (m/sec) Median motor 51 Median sensory 42 Ulnar motor 52 Ulnar sensory 49 Posterior tibial motor 39 Sural sensory 47 Peroneal sensory Peroneal mixed Peroneal motor ankle/above the head of fibula/ 12.9 (above the head of fibula
) below the head of fibula
16.0 (below the head of fibula
) Table 2.
Key: HF= Head of fibula
; 1= Inferior; L= Lateral; LS= Lateral surface; M= Medial; NF= Nutrient foramen; S= Superior.
To stabilize the graft a K wire was passed from 3rd metacarpal to the head of fibula
. The inferior fibular joint created is fixed with K wire passed from head of ulna to the head of fibula
This case is rare because of the involvement of the head of fibula
that destroyed cortex but spared the adjacent synovial joint, mimicking a neoplastic rather than infectious process.
The Ottawa knee rules indicate radiography if any of the following factors are present: (1) patient older than 55, (2) tenderness present at the head of fibula
, (3) isolated tenderness over the patella, (4) inability to flex knee to 90 degrees, or (5) inability to transfer weight for four steps both immediately after the injury and in the emergency department (ED).
Lithotomy position mainly used for vaginal hysterectomy has been found responsible for common peroneal neuropathy where there will be compression of common peroneal nerve at the head of fibula
due to direct pressure by the metal stand.
When it does occur, it can articulate with the lateral condyle of the tibia and lies very close to the head of fibula
. It is within the popliteus muscle and is therefore a sesamoid bone (Le Minor, 1992).