ABSTRACT
Traumatic damage to the common peroneal nerve due to sharp injury, gunshot wound, sciatic nerve tumor, radiculopathy, or hip replacement surgery may result in foot drop. We present an alternative strategy for reanimation of foot drop following deep peroneal nerve palsy, successfully restoring voluntary movement. Fourteen consecutive patients with deep peroneal nerve injuries resulting in foot drop underwent nerve transfer of functional fascicles of either the superficial peroneal nerve or of the tibial nerve as donor for deep peroneal-innervated muscle groups. Eleven cases had successful restoration of British motor grade 3+ to 4+/5 ankle dorsiflexion, one case had restoration of grade 3 ankle dorsiflexion, and two cases had no restoration of dorsiflexion. Nerve transfer to the deep peroneal nerve is a feasible and effective method of treating deep peroneal nerve injuries of less than 1-year duration.
KEYWORDS
Gait - drop foot - nerve transfer - neuropathy - deep peroneal - peripheral nerves - reconstructive surgical procedures
REFERENCES
-
1
Hove L M, Nilsen P T.
Posterior tibial tendon transfer for drop-foot: 20 cases followed for 1–5 years.
Acta Orthop Scand.
1998;
69
608-610
-
2
Yeap J S, Birch R, Singh D.
Long-term results of tibialis posterior tendon transfer for drop-foot.
Int Orthop.
2001;
25
114-118
-
3
Johnson K A, Strom D E.
Tibialis posterior tendon dysfunction.
Clin Orthop Relat Res.
1989;
239
196-206
-
4
Nath R K, Mackinnon S E.
Nerve transfers in the upper extremity.
Hand Clin.
2000;
16
131-139
ix
-
5
Terzis J K, Kostas I.
Suprascapular nerve reconstruction in 118 cases of adult posttraumatic brachial plexus.
Plast Reconstr Surg.
2006;
117
613-629
-
6
Brunelli G A, Brunelli G A.
Reconstructive surgery for permanent palsy of the median nerve.
Surg Technol Int.
2004;
13
268-275
-
7
Oberlin C, Beal D, Leechavengvongs S, Salon A, Dauge M C, Sarcy J J.
Nerve transfer to biceps muscle using a part of ulnar nerve for C5–C6 avulsion of the brachial plexus: anatomical study and report of four cases.
J Hand Surg [Am].
1994;
19
232-237
-
8
Urushidani H.
The funicular pattern of the sciatic nerve in Japanese adults (author's trans.)
Nippon Geka Hokan.
1974;
43
254-275
-
9 Mackinnon S E, Dellon A L. Surgery of the Peripheral Nerve. New York, Stuttgart; Thieme Medical Publishers 1988
-
10
Narakas A O, Hentz V R.
Neurotization in brachial plexus injuries: indication and results.
Clin Orthop Relat Res.
1988;
237
43-56
-
11
Kim D H, Murovic J A, Tiel R, Kline D G.
Management and outcomes in 353 surgically treated sciatic nerve lesions.
J Neurosurg.
2004;
101
8-17
-
12 Sunderland S. Nerve Injuries and Their Repair: A Critical Appraisal. Edinburgh, New York; Churchill Livingstone 1991
-
13
Weber R V, Mackinnon S E.
Bridging the neural gap.
Clin Plast Surg.
2005;
32
605-616
-
14
Trumble T E, Vanderhooft E, Khan U.
Sural nerve grafting for lower extremity nerve injuries.
J Orthop Trauma.
1995;
9
158-163
-
15
Gosk J, Rutowski R, Rabczynski J.
The lower extremity nerve injuries: own experience in surgical treatment.
Folia Neuropathol.
2005;
43
148-152
-
16
Gousheh J, Babaei A.
A new surgical technique for the treatment of high common peroneal nerve palsy.
Plast Reconstr Surg.
2002;
109
994-998
-
17
Bodily K D, Spinner R J, Bishop A T.
Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: an anatomical study.
Clin Anat.
2004;
17
201-205
-
18
Buyukmumcu M, Ustun M E, Seker M, Kocaogullari Y, Sagmanligil A.
The possibility of deep peroneal nerve neurotisation by the superficial peroneal nerve: an anatomical approach.
J Anat.
1999;
194(Pt 2)
309-312
-
19 Birch R, Bonney G, Wynn Parry C B. Surgical Disorders of the Peripheral Nerves. London; Churchill Livingstone 1998
-
20
Garozzo D, Ferraresi S, Buffatti P.
Surgical treatment of common peroneal nerve injuries: indications and results. A series of 62 cases.
J Neurosurg Sci.
2004;
48
105-112
discussion 112
-
21
Ferraresi S, Garozzo D, Buffatti P.
Common peroneal nerve injuries: results with one-stage nerve repair and tendon transfer.
Neurosurg Rev.
2003;
26
175-179
Rahul K NathM.D.
2201 W. Holcombe Blvd., Suite 225
Houston, TX 77030
Email: rnath@drnathmedical.com
