Lower extremity peripheral nerve syndromes

Nerve	Site of injury	Cause	Symptoms	Signs
Common peroneal	Fibular neck, just below the knee	Prolonged lying, leg crossing, squatting, leg cast	Foot drop, paresthesias and/or sensory loss over dorsum of foot and lateral shin	Weakness on foot dorsiflexion and eversion; sensory loss on dorsum of foot; reflexes normal
Deep peroneal	Ankle	Tight fitting shoe rim or strap	Ankle pain, minimal weakness and sensory loss over web space between digits 1 and 2	Minimal
Posterior tibial	Tarsal tunnel of ankle	Fracture or dislocation of talus, calcaneus, medial malleolus, rheumatoid arthritis, tumor	Aching, burning, numbness, tingling on sole of foot, distal foot, toes, and occasionally heel	Positive Tinel's sign over nerve posterior to medial malleolus; sensory loss on sole of foot; atrophy of foot muscles if severe
Sciatic	Sciatic notch/gluteal region	Trauma (hip dislocation, fracture, or replacement), prolonged bed rest, deep-seated pelvic mass, piriformis syndrome	Leg pain and weakness affecting most lower leg muscles	Sensory loss in peroneal, tibial, and sural territories; may spare medial calf and arch of foot; normal knee jerk; absent ankle jerk
Sciatic	Mid-thigh	Femur fracture, mass, ischemic nerve infarction	Similar to above but sparing hamstrings	Similar to above
Femoral	Pelvis and anterior thigh	Hip or pelvic fracture, hip replacement, lithotomy position, diabetes mellitus	Quadriceps weakness and sensory loss	Quadriceps weakness; sensory loss over anterior and medial thigh extending down medial shin to arch of foot; reduced or unobtainable knee jerk
Lateral femoral cutaneous	Inguinal ligament (meralgia paresthetica)	Obesity, tight fitting belts, idiopathic	Paresthesias and pain radiating down the lateral thigh to knee	Sensory loss on lateral thigh

Graphic 78221 Version 3.0

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Lower extremity peripheral nerve syndromes