What positioning practice helps prevent peroneal nerve injury during lithotomy or lateral surgeries?

• A. Proper padding and leg positioning, avoiding compression.
• B. Pad only arms.
• C. Position with no padding.
• D. Forceful leg extension.

Answer: (A)

Preventing peroneal nerve injury hinges on preventing external compression and undue stretch of the nerve around the fibular head when the legs are in lithotomy or lateral positions. The common peroneal nerve runs superficially at the fibular neck and is vulnerable to pressure from leg supports, stirrups, and firm surfaces. Using well-padded supports and distributing pressure away from the fibular head protects this area, while keeping the legs in neutral alignment and avoiding excessive knee flexion, ankle dorsiflexion, or external rotation reduces the risk of nerve traction or compression. In lithotomy, padding along the posterior knee and calf and choosing supports that do not press on the fibular head helps; in the lateral position, padding the dependent leg and avoiding direct pressure on the knee and lateral leg structures preserves circulation and nerve integrity. This approach directly addresses the mechanism of injury, unlike padding only the arms, having no padding, or forcing leg positions that increase nerve stretch.