The common peroneal nerve is vulnerable to injury because of its anatomical characteristics. Numerous factors can cause compressive common peroneal neuropathy. The fabella is a sesamoid bone present in 10-30% of the population, usually in the lateral head of the gastrocnemius muscle, and considered of limited clinical significance. We present a 74-year-old woman with drop foot and leg numbness. A nerve conduction velocity (NCV) test and electromyography (EMG) revealed common peroneal neuropathy. Magnetic resonance imaging (MRI) showed an increased T2 signal around the nerve, which was compessed by a 2 cm fabella from beneath. After surgical exploration of the common peroneal nerve and excision of the fabella, the patient showed significant recovery. Nerve compression caused by the fabella is extremely rare, with few published articles. The NCV test, EMG, and MRI play a key role in the differential diagnosis, prompt surgical exploration, and excision of the fabella provide favorable results.
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