Foot Drop.....Peroneal Nerve Damage

[nattydread]

had a motorcycle accident 10 months ago and had a whack on the back of my leg above the knee that has resulted in foot drop.......the doctor in Chiang Mai Ram hospital said it should recover on its own but would take at least 6 months......the upward movement in the foot has not returned so i would now like to have more investigations into the problem so i am looking for a hospital/ doctor that specialises in this field..........am happy to travel to Bangkok if required.....thanks for any advice

[THAIPHUKET]

I have the same problem, however since 20 years, the Peroneal nerve can but must not grow together again. Since then I am wearing a brace which keeps the foot in 90 degrees, it works fine for me.

The big risk of a drop foot is that you very prone to falling. I am in CM. If you want, come by, have look , try one, I've got several and take it from there. The brace is made of carbon fiber , extremely light and flexible so no risk that the ankle freezes due to immobility. Custom made in Germany.

[Bung]

I am dealing with Ulnar nerve damage in my hand and they did an "EMG" test to check the extent of the nerve damage by electrical stimulation. I was seeing the doc at Ram and she sent me to Srithep hospital for the test. It may be worth asking about that.

[Sheryl]

As you are in Chiang Mai, start by seeing an orthopedic surgeon at Sri Pat. See this link for more description/directions:

If this does not prove satisfactory then your next recourse should be to one of the following specialists at Bumrungrad in Bkk. You will likely need nerve conduction studies and those can be costly so if you can do at least that at Sripat and bring the findings with you it will save considerable $$:

Dr. Wichan Kanchanatawan

Dr. Mason Porramatikul

Dr. Channarong Kasemkijwattana

Wng Cdr Dr. Ekapong Komolhiran

Dr. Vatanachai Rojvanit

Dr. Panya Wongpatimachai

You can review the qualifications of all these doctors at http://www.bumrungrad.com/en/search-for-a-thailand-doctor

Also if you want help narrowing down the choice, I suggest you PM TV member Bumrungrad (name is Scott).

[THAIPHUKET]

Sheryl's advise is always very valuable, this is my personal experience I can vouch for.

Question Sheryl=

Would such an examination produce any new insights how perhaps to reconstruct a nerve has has been dysfunctional for over 20 years?

[Sheryl]

It would confirm exactly which nerves are affected and to what extent, which may be useful if not already known. It will also tell what the condition of collateral and adjacent nerves are like, which may help if surgical treatment such as nerve grafting is contemplated.

You would do best to get in touch with a plastic surgeon specializing in reconstructive (as opposed to cosmetic) surgery. Given how much time has elapsed, both a nerve graft and a muscle transfer may be necessary.

Try Dr. Vichai Srimuninnimit at Bumrungrad. He is a Professor at Ramithodi and has a lot of reconstructive experience.

Such surgery would be quite expensive so ask some hard questions as to percentage chance of regaining all or partial function

[bunnaag]

As you are in Chiang Mai, start by seeing an orthopedic surgeon at Sri Pat. See this link for more description/directions:

http://www.thaivisa....al-specialists/

If this does not prove satisfactory then your next recourse should be to one of the following specialists at Bumrungrad in Bkk. You will likely need nerve conduction studies and those can be costly so if you can do at least that at Sripat and bring the findings with you it will save considerable $$:

Dr. Wichan Kanchanatawan

Dr. Mason Porramatikul

Dr. Channarong Kasemkijwattana

Wng Cdr Dr. Ekapong Komolhiran

Dr. Vatanachai Rojvanit

Dr. Panya Wongpatimachai

You can review the qualifications of all these doctors at http://www.bumrungra...thailand-doctor

Also if you want help narrowing down the choice, I suggest you PM TV member Bumrungrad (name is Scott).

can you recommend ay doctor specializing in neuropathy?

[THAIPHUKET]

Sheryl,

I think I leave as is, not because of cost but because I know peripheral nerves are also badly damaged, e.g. twisting the whole leg to left/right is hardly possible. Sounds like another major operation and long recovering time would be needed with a questionable outcome. I think I have better use of my time. The brace is no bother, running the marathon not my goal. But I will never stop to look for betterment if the yield is right.

[FBN]

The nerve can only heal if the nerve sheath is intact. (If not, this needs to be surgically repaired). The nerve grows about as fast as a nail so it will take that long as the rest of the nerve below the impact will usually die and will need to be replace from the upper, healthy end. Peroneal nerve damage is usually bad news on the long term. An EMG will be needed to determine the damage and wearing a brace in the mean time is essential.

[THAIPHUKET]

FBN says it right

it will take that long as the rest of the nerve below the impact will usually die

[nattydread]

reading on the internet the bruise i had on the back of my leg after the accident was quite considerable and i am looking at the idea that there has been a lot of scar tissue formed around the nerve at that point.....i have read that some people have had nerve decompression surgery which is exploratory surgery at the site to cut away any scar tissue impinging on the nerve and affecting its performance.......anybody heard of this procedure???????????

[FBN]

reading on the internet the bruise i had on the back of my leg after the accident was quite considerable and i am looking at the idea that there has been a lot of scar tissue formed around the nerve at that point.....i have read that some people have had nerve decompression surgery which is exploratory surgery at the site to cut away any scar tissue impinging on the nerve and affecting its performance.......anybody heard of this procedure???????????

Nerve compression and the exact area where it is compressed can only be diagnosed accurately with an EMG study. Surgical exploration without that info is usually not done and can cause more damage..

[THAIPHUKET]

I would get a second, perhaps a third opinion. The task will be to find someone who can read the EMG correctly and then to find a neurosurgeon with lots, lots of experience, not someone who does this of and on.