Foot reanimation via nerve transfer to the peroneal nerve using the nerve branch to the lateral gastrocnemius: Case report

Strazar, Robert; White, Colin; Bain, James R.

doi:10.1016/j.bjps.2011.02.025

Cited by 19 publications

(13 citation statements)

References 4 publications

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“…Only 6 studies have evaluated foot drop outcomes following DNT. 1,2,[17][18][19][20] These studies are small, ranging from one 19 to 16 patients. 20 The percentage of patients obtaining at least an MRC grade 3 (movement against gravity) is highly variable, between 20% 18 and 78%, 1 with an average grade of 2.1.…”

Section: Discussionmentioning

confidence: 99%

Conditioning Electrical Stimulation Accelerates Regeneration in Nerve Transfers

Senger

Rabey

Morhart

et al. 2020

Annals of Neurology

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Objective Compared to the upper limb, lower limb distal nerve transfer (DNT) outcomes are poor, likely due to the longer length of regeneration required. DNT surgery to treat foot drop entails rerouting a tibial nerve branch to the denervated common fibular nerve stump to reinnervate the tibialis anterior muscle for ankle dorsiflexion. Conditioning electrical stimulation (CES) prior to nerve repair surgery accelerates nerve regeneration and promotes sensorimotor recovery. We hypothesize that CES prior to DNT will promote nerve regeneration to restore ankle dorsiflexion. Methods One week following common fibular nerve crush, CES was delivered to the tibial nerve in half the animals, and at 2 weeks, all animals received a DNT. To investigate the effects of CES on nerve regeneration, a series of kinetic, kinematic, skilled locomotion, electrophysiologic, and immunohistochemical outcomes were assessed. The effects of CES on the nerve were investigated. Results CES‐treated animals had significantly accelerated nerve regeneration (p < 0.001), increased walking speed, and improved skilled locomotion. The injured limb had greater vertical peak forces, with improved duty factor, near‐complete recovery of braking, propulsive forces, and dorsiflexion (p < 0.01). Reinnervation of the tibialis anterior muscle was confirmed with nerve conduction studies and immunohistochemical analysis of the neuromuscular junction. Immunohistochemistry demonstrated that CES does not induce Wallerian degeneration, nor does it cause macrophage infiltration of the distal tibial nerve. Interpretation Tibial nerve CES prior to DNT significantly improved functional recovery of the common fibular nerve and its muscle targets without inducing injury to the donor nerve. ANN NEUROL 2020;88:363–374.

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Section: Discussionmentioning

confidence: 99%

Conditioning Electrical Stimulation Accelerates Regeneration in Nerve Transfers

Senger

Rabey

Morhart

et al. 2020

Annals of Neurology

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“…47 The disadvantages include reduced calf circumference and usually subclinical reduction in plantar flexion. 43,48 Strazar and colleagues 49 reported a case of an 18-year-old male patient who achieved M4 recovery in tibialis anterior 24 months after neurotization for common peroneal nerve palsy after a closed injury. Nath and colleagues 48 had excellent results where 11 out of 14 patients achieved ankle dorsiflexion against minimal resistance.…”

Section: Alternative Optionsmentioning

confidence: 97%

An Evidence-Based Structured Review to Assess the Results of Common Peroneal Nerve Repair

George

Boyce

2014

Plastic and Reconstructive Surgery

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“…Consequently, there has been considerable variability in the reported outcomes with the use of nerve transfers in peroneal nerve palsy. 1,2,[13][14][15][16][17] The objective of this work was to perform a systematic review and meta-analysis of the primary literature to assess the effectiveness of nerve transfer surgery in restoring ankle dorsiflexion in patients with peroneal nerve palsy.…”

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confidence: 99%