Neurovascular Compression Following Isolated Popliteus Muscle Rupture: A Case Report

This case report concerns an unusual complication of neurovascular compression following an isolated
popliteus muscle rupture. A 59-year-old man, after a fall from a horse, gradually developed symptoms
of a swollen leg, dysesthesias in the sole of his foot, and muscle weakness of his toe flexors. At
presentation, he was found to have a complete tibial nerve injury at the level of the popliteal fossa and
significant neuropathic pain. MRI demonstrated a rupture in the muscular portion of the popliteusmuscle
with extensive edema and hemorrhage compressing the tibial nerve in the popliteal fossa. The edema
extended up to the distal part of sciatic nerve where there was evidence of intraneural hemorrhage. In the
course of recovery, the patient additionally developed deep venous thrombosis in the ipsilateral popliteal
vein. Spontaneous recovery was documented on serial clinical and electrodiagnostic examinations. The
patient’s neuropathic pain improved significantly within 6 months and his neurologic function recovered
nearly fully by 2 years. (Journal of Surgical Orthopaedic Advances 14(3):129–132, 2005)
Key words: deep venous thrombosis, isolated popliteus muscle rupture, sciatic nerve compression,
tibial nerve compression