A 25-year-old male was kicked with an ice skate on the lateral surface of his left leg just inferior to the knee while p
Posted: Thu Jun 30, 2022 7:24 pm
A 25-year-old male was kicked with an ice skate on the lateral surface of his left leg just inferior to the knee while playing in a hockey game. The superficial laceration was treated by the athletic trainer, but the player was unable to continue playing. He complained of pain in the region of the wound with an associated numbness and tingling to the lateral surface of his left leg and the dorsum of his left foot. Upon removal of his skates, the player was unable to dorsiflex his left foot or extend his toes. In an attempt to walk, he experienced a sharp pain to the lateral aspect of his left leg just below his knee with each step. He was sent to the emergency room.
Upon arrival to the emergency room, the physician noted that the patient had an abnormal gait. The patient raised his left foot higher than usual during the swing phase and his foot came down abruptly following heel strike. While the patient sat on the examination table, his left foot assumed a more plantarflexed position when compared to the right. On physical examination, the patient was noted to have subjective tenderness over the head and neck of the fibula and a sensory deficit on the lateral side of the distal part of the left leg, including the dorsum of the foot. An x-ray of the left lower extremity confirmed a fracture of the neck of the fibula. The patient was diagnosed with a left fibular neck fracture with peripheral nerve injury.
Questions:
1. What nerve is most likely injured in this patient?
2. Describe the anatomical relationship that makes this nerve vulnerable to injury.
3. Discuss the anatomical basis of the loss of sensation an impaired function in the patient's foot.
4. Describe the compensation mechanism using anatomical structures.
5. Why did the patient experience pain with walking if the fibula is not weight bearing?
Upon arrival to the emergency room, the physician noted that the patient had an abnormal gait. The patient raised his left foot higher than usual during the swing phase and his foot came down abruptly following heel strike. While the patient sat on the examination table, his left foot assumed a more plantarflexed position when compared to the right. On physical examination, the patient was noted to have subjective tenderness over the head and neck of the fibula and a sensory deficit on the lateral side of the distal part of the left leg, including the dorsum of the foot. An x-ray of the left lower extremity confirmed a fracture of the neck of the fibula. The patient was diagnosed with a left fibular neck fracture with peripheral nerve injury.
Questions:
1. What nerve is most likely injured in this patient?
2. Describe the anatomical relationship that makes this nerve vulnerable to injury.
3. Discuss the anatomical basis of the loss of sensation an impaired function in the patient's foot.
4. Describe the compensation mechanism using anatomical structures.
5. Why did the patient experience pain with walking if the fibula is not weight bearing?