The dangers of hemilithotomy positioning on traction tables: case report of a well-leg drop foot after contralateral femoral nailing

BACKGROUND: Postoperative contralateral morbidities after fracture fixation surgery by hemilithotomy positioning on traction table is uncommon. We’d report a case of unexpected common peroneal nerve palsy developed on the contralateral side manifesting with drop foot after a common orthopedic femoral nailing. CASE REPORT: A 28-year-old female sustained an unusual common peroneal nerve palsy manifesting contralateral drop foot after prolonged femoral nailing. Although the initial presentations were similar to the notorious well-leg compartment syndrome, a benign course with complete recovery in functions was observed 3 months later. After neurophysiologic exam and review of pertinent literature, this iatrogenic and transient dysfunction was delineated to be position-related neuropraxia. CONCLUSION: Position adjustment at intervals or complete avoidance of prolonged knee hyperflexion is recommended to prevent contralateral common peroneal nerve morbidity.