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Nerve and Tendon Lacerations About the Foot and Ankle

Dr. Thordarson is Vice Chair, Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA. Dr. Shean is Associate Physician, Kaiser Permanente, Baldwin Park, CA.

Reprint requests: Dr. Thordarson, USC Department of Orthopaedic Surgery, GNH 3900, 1200 North State Street, Los Angeles, CA 90033.

Nerve and tendon lacerations of the foot and ankle region are relatively common. Acute nerve and tendon injuries should be repaired with appropriate techniques at the time of initial wound exploration. Primary nerve repair may help minimize the risk of painful neuroma formation; primary tendon repair can lead to better functional results than delayed repair. Most chronic nerve injuries, except those to the tibial nerve or its major divisions, are managed by resection of a painful neuroma and burying the nerve ending in a protected area. Delayed reconstruction of tendon injuries is performed when correction of the functional deficit outweighs the morbidity of surgery.