Table 2. Comparative analysis of sural nerve entrapment cases following calcaneal fracture repair.

This table presents a comparison between the current case and a previously reported instance of sural neuropathy following calcaneal fracture surgery. Notable differences highlight how the underlying cause of nerve entrapment, whether due to hardware or isolated scar tissue, significantly influences treatment strategies and outcomes. While hydrodissection served as a temporary measure in cases involving hardware, it proved to be a definitive and curative approach for entrapment caused solely by post-surgical fibrosis, even when prior hardware removal had already been performed. Additionally, the choice of injectate may play a crucial role in determining the durability of treatment efficacy.

Source: Reference [5].

Feature	Omodani T and Takahashi K (2023) Case	Current Case
Primary cause of entrapment	Hardware-related, pain was likely due to a combination of scar tissue and the physical presence of the fixation plate.	Scar tissue alone, entrapment persisted even after elective hardware removal, isolating the cause to post-surgical fibrosis.
Intervention	Hydrodissection (with 0.09% lidocaine) provided significant but temporary relief.	Hydrodissection (with 5% dextrose in water (D5W)) provided definitive, sustained relief after two sessions.
Ultimate resolution	Required subsequent surgery (plate removal and neurolysis) for complete symptom resolution.	Achieved with hydrodissection alone , no further surgery was required.
Injectate	0.09% lidocaine (a short-acting local anesthetic).	5% dextrose in water (D5W) without local anesthetic , a potentially therapeutic, mild neurolytic agent.
Clinical implication	Hydrodissection can serve as a useful bridging or diagnostic therapy in complex cases with hardware but may not be definitive.	Hydrodissection can be a curative, standalone treatment for pure scar tissue entrapment, even in refractory cases.
Key message	Hydrodissection is a valuable tool, but hardware removal may still be necessary for complete resolution.	For isolated sural nerve entrapment within scar tissue, hydrodissection can obviate the need for repeat surgery.