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Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: The Inselspital Bern Experience.
Neurosurgery. 2015 Oct; 77(4):572-9; discussion 579-80.N

Abstract

BACKGROUND

Patients in whom conventional peroneal nerve repair surgery failed to reconstitute useful foot lift need to be evaluated for their suitability to undergo a concomitant tendon transfer procedure or nerve transfers.

OBJECTIVE

To report our first clinical experience with nerve transfers for persistent traumatic peroneal nerve palsy.

METHODS

Between 2007 and 2013, 8 patients were operated on for foot drop after unsuccessful nerve surgery. Six patients without fatty degeneration of the anterior tibial muscle and proximal lesion of the peroneal nerve were oriented for tibial to peroneal nerve transfer. In the other 2 cases where the anterior and lateral compartments were destructed, the anterior tibial muscle function was reconstructed with a neurotized lateral gastrocnemius transfer. For each patient, we graded postoperative results using the British Medical Research Council scheme and the Ninkovic assessment scale.

RESULTS

Of the 6 patients who underwent nerve transfer of the anterior tibial muscle, 2 patients had excellent results, 1 patient had good results, 1 patient had fair results, and 2 patients had poor results. Of the 2 patients that underwent neurotized lateral gastrocnemius transfer, 1 patient achieved excellent results after tenolysis, whereas 1 patient achieved poor results. After the nerve transfer, 5 patients did not wear an ankle-foot orthosis. Four patients did not limp. Four patients were able to walk barefoot, navigate stairs, and participate in activities.

CONCLUSION

Early clinical results after tibial to peroneal nerve transfer and neurotized lateral gastrocnemius transfer appear mixed. The results of nerve transfer seem, on the whole, less reliable than the literature reports on tendon transfer.

Authors+Show Affiliations

Department of Plastic Surgery and Hand Surgery, INSELSPITAL Bern, University of Bern, Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26164725

Citation

Leclère, Franck Marie, et al. "Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: the Inselspital Bern Experience." Neurosurgery, vol. 77, no. 4, 2015, pp. 572-9; discussion 579-80.
Leclère FM, Badur N, Mathys L, et al. Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: The Inselspital Bern Experience. Neurosurgery. 2015;77(4):572-9; discussion 579-80.
Leclère, F. M., Badur, N., Mathys, L., & Vögelin, E. (2015). Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: The Inselspital Bern Experience. Neurosurgery, 77(4), 572-9; discussion 579-80. https://doi.org/10.1227/NEU.0000000000000897
Leclère FM, et al. Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: the Inselspital Bern Experience. Neurosurgery. 2015;77(4):572-9; discussion 579-80. PubMed PMID: 26164725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: The Inselspital Bern Experience. AU - Leclère,Franck Marie, AU - Badur,Nicole, AU - Mathys,Lukas, AU - Vögelin,Esther, PY - 2015/7/13/entrez PY - 2015/7/15/pubmed PY - 2016/5/14/medline SP - 572-9; discussion 579-80 JF - Neurosurgery JO - Neurosurgery VL - 77 IS - 4 N2 - BACKGROUND: Patients in whom conventional peroneal nerve repair surgery failed to reconstitute useful foot lift need to be evaluated for their suitability to undergo a concomitant tendon transfer procedure or nerve transfers. OBJECTIVE: To report our first clinical experience with nerve transfers for persistent traumatic peroneal nerve palsy. METHODS: Between 2007 and 2013, 8 patients were operated on for foot drop after unsuccessful nerve surgery. Six patients without fatty degeneration of the anterior tibial muscle and proximal lesion of the peroneal nerve were oriented for tibial to peroneal nerve transfer. In the other 2 cases where the anterior and lateral compartments were destructed, the anterior tibial muscle function was reconstructed with a neurotized lateral gastrocnemius transfer. For each patient, we graded postoperative results using the British Medical Research Council scheme and the Ninkovic assessment scale. RESULTS: Of the 6 patients who underwent nerve transfer of the anterior tibial muscle, 2 patients had excellent results, 1 patient had good results, 1 patient had fair results, and 2 patients had poor results. Of the 2 patients that underwent neurotized lateral gastrocnemius transfer, 1 patient achieved excellent results after tenolysis, whereas 1 patient achieved poor results. After the nerve transfer, 5 patients did not wear an ankle-foot orthosis. Four patients did not limp. Four patients were able to walk barefoot, navigate stairs, and participate in activities. CONCLUSION: Early clinical results after tibial to peroneal nerve transfer and neurotized lateral gastrocnemius transfer appear mixed. The results of nerve transfer seem, on the whole, less reliable than the literature reports on tendon transfer. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/26164725/Nerve_Transfers_for_Persistent_Traumatic_Peroneal_Nerve_Palsy:_The_Inselspital_Bern_Experience_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/NEU.0000000000000897 DB - PRIME DP - Unbound Medicine ER -