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Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop.
Neurosurgery. 2013 Oct; 73(4):609-15; discussion 615-6.N

Abstract

BACKGROUND

Foot drop is a very debilitating condition affecting patients' daily activities, and its treatment has been a challenge for neurosurgeons. Grafting the peroneal or sciatic nerve usually results in poor outcomes. Our previous anatomic study demonstrated the feasibility of transferring a motor branch of the tibial nerve to the deep peroneal nerve at the level of the popliteal fossa.

OBJECTIVE

To demonstrate the outcomes obtained after the transfer of a branch of the tibial nerve to the peroneal nerve for recovery of foot drop.

METHODS

A retrospective review of 13 patients with foot drop caused by injuries to a lumbar root or the sciatic or peroneal nerve, who underwent a transfer of the nerve of the soleus muscle to the deep peroneal nerve. The results were evaluated using the British Medical Research Council grading system.

RESULTS

Three patients were lost to follow-up. Of the remaining 10 patients, the outcomes were considered good (Medical Research Council grade M3 or M4) in 2 patients (20%) concerning ankle dorsiflexion and in 2 patients concerning toe extension (20%). One patient reported a reduced calf circumference.

CONCLUSION

The transfer of the nerve of the soleus muscle to the deep peroneal nerve demonstrated poor results in most of the patients, although favorable outcomes were observed in a few subjects. Due to the inconsistency of the results, we do not favor the routine use of this technique for the treatment of foot drop.

Authors+Show Affiliations

†Unit of Neurosurgery, Hospital de Base do Distrito Federal, Brasília, Distrito Federal, Brazil; ‡Hospital Santa Helena, Brasília, Distrito Federal, Brazil; §Peripheral Nerve Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23839519

Citation

Flores, Leandro Pretto, et al. "Clinical Results of Transferring a Motor Branch of the Tibial Nerve to the Deep Peroneal Nerve for Treatment of Foot Drop." Neurosurgery, vol. 73, no. 4, 2013, pp. 609-15; discussion 615-6.
Flores LP, Martins RS, Siqueira MG. Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop. Neurosurgery. 2013;73(4):609-15; discussion 615-6.
Flores, L. P., Martins, R. S., & Siqueira, M. G. (2013). Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop. Neurosurgery, 73(4), 609-15; discussion 615-6. https://doi.org/10.1227/NEU.0000000000000062
Flores LP, Martins RS, Siqueira MG. Clinical Results of Transferring a Motor Branch of the Tibial Nerve to the Deep Peroneal Nerve for Treatment of Foot Drop. Neurosurgery. 2013;73(4):609-15; discussion 615-6. PubMed PMID: 23839519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop. AU - Flores,Leandro Pretto, AU - Martins,Roberto Sérgio, AU - Siqueira,Mario Gilberto, PY - 2013/7/11/entrez PY - 2013/7/11/pubmed PY - 2014/5/3/medline SP - 609-15; discussion 615-6 JF - Neurosurgery JO - Neurosurgery VL - 73 IS - 4 N2 - BACKGROUND: Foot drop is a very debilitating condition affecting patients' daily activities, and its treatment has been a challenge for neurosurgeons. Grafting the peroneal or sciatic nerve usually results in poor outcomes. Our previous anatomic study demonstrated the feasibility of transferring a motor branch of the tibial nerve to the deep peroneal nerve at the level of the popliteal fossa. OBJECTIVE: To demonstrate the outcomes obtained after the transfer of a branch of the tibial nerve to the peroneal nerve for recovery of foot drop. METHODS: A retrospective review of 13 patients with foot drop caused by injuries to a lumbar root or the sciatic or peroneal nerve, who underwent a transfer of the nerve of the soleus muscle to the deep peroneal nerve. The results were evaluated using the British Medical Research Council grading system. RESULTS: Three patients were lost to follow-up. Of the remaining 10 patients, the outcomes were considered good (Medical Research Council grade M3 or M4) in 2 patients (20%) concerning ankle dorsiflexion and in 2 patients concerning toe extension (20%). One patient reported a reduced calf circumference. CONCLUSION: The transfer of the nerve of the soleus muscle to the deep peroneal nerve demonstrated poor results in most of the patients, although favorable outcomes were observed in a few subjects. Due to the inconsistency of the results, we do not favor the routine use of this technique for the treatment of foot drop. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/23839519/Clinical_results_of_transferring_a_motor_branch_of_the_tibial_nerve_to_the_deep_peroneal_nerve_for_treatment_of_foot_drop_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/NEU.0000000000000062 DB - PRIME DP - Unbound Medicine ER -