Neuromusculotendinous Transfer

Ninković, Milomir; Ninković, Marina

doi:10.1097/prs.0b013e31829ad035

Cited by 19 publications

(6 citation statements)

References 25 publications

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“…To effectively assess patients with foot drop, functional evaluation along with MRC grading of the anterolateral compartment of the lower leg is necessary. Ninković and Ninković [ 8 ] proposed a grading scale for assessing functional outcomes after neuromusculotendinous transfer for peroneal neuropathy. However, Ninkovic grading requires clinicians to perform EMG and to evaluate ankle dorsiflexion and plantarflexion, active range of motion of the ankle, joint motion, and walking.…”

Section: Discussionmentioning

confidence: 99%

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

Kim

Yang

Cho

et al. 2023

J Korean Neurosurg Soc

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Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

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Section: Discussionmentioning

confidence: 99%

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

Kim

Yang

Cho

et al. 2023

J Korean Neurosurg Soc

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“…The Ninkovic procedure is another treatment for persistent peroneal nerve palsy. 13 Here, one or both heads of the gastrocnemius muscle is transposed to the tendons of the anterior muscle group, with simultaneous transposition of the undamaged proximal part of the deep peroneal nerve to the motor branch of the tibial nerve supplying the gastrocnemius muscle. This transfer requires a supple ankle joint across which the transferred muscle can act.…”

Section: Nervesmentioning

confidence: 99%

“…A recent study by Ninkovic demonstrated that signs of reinnervation occur on an average of 6 months after the operation, and most patients achieve full automatic walking and voluntary movement of the transferred muscle. 13 In contrast to the tibialis posterior muscle transfer, no re-education of the transfer muscle is needed in the Ninkovic procedure.…”

Section: Nervesmentioning

confidence: 99%

Reconstruction Options for Lower Extremity Traumatic Wounds

Azoury

Kovach

Levin

2022

J Am Acad Orthop Surg

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The senior author first coined the "orthoplastic" approach to traumatic lower extremity reconstruction, by which multidisciplinary surgeons and specialists work together for optimal patient success. The goals of lower extremity salvage are to optimize limb appearance, restore unrestricted pain-free ambulation, and improve quality of life. Composite traumatic defects require an organized approach, and the reconstructive ladder is used for strategies of varying complexity for repair of soft-tissue wounds. The lower rungs of the ladder include simpler reconstructive options such as the use of skin grafts and local flaps, and the higher rungs represent complex techniques such as free tissue transfer. Although there is no notable difference between muscle and fasciocutaneous/perforator flaps in reconstructive outcomes, there has been a trend toward perforator flaps to minimize donor site morbidity.T rauma is one of the most common antecedent etiologies for lower extremity wounds, both acute and chronic. The care of traumatized lower extremity patients necessitates an orthoplastic approach, first coined by the senior author (L.S.L.), by which multidisciplinary surgeons and specialists all work together to ensure optimal patient success. 1 Early treatment of a patient sustaining severe lower extremity trauma at a specialized orthoplastic limb salvage center should be the standard of care, and the lower extremity guidelines for salvage should be widely embraced to expedite referrals. [2][3][4] The goals of limb salvage are to optimize limb appearance, restore unrestricted pain-free ambulation, and improve quality of life. Our algorithm for the management of composite defects of the lower extremity below the knee has been previously described (Figure 1). 5,6 Blood flow should be restored, devitalized tissue débrided, bony defects or fractures stabilized, and missing soft-tissue implants replaced. When deciding the optimal tissue type for coverage, the reconstructive ladder is used: the lower rungs of the ladder include options such as skin grafts and local flaps and the higher rungs represent complex techniques such as microvascular free tissue transfer. The ladder is also expanding with options for the lower extremity amputee patient, including osseointegration, targeted muscle reinnervation, Saı ¨d C. Azoury, MD

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“…Ideally, the current control law [7] results in the inductor current i[n] following the current command i c within one switching cycle [13]. In addition, by selecting a sufficiently small low-pass averaging filter parameter α, the average duty cycle D is computed at high resolution, which enables current-mode control realization using a low-resolution current A/D converter.…”

Section: Protectionmentioning

confidence: 99%

“…Various auxiliary schemes have been proposed to mitigate the problem, such as: pulse dropping or decreasing the switching frequency [1][2][3][4][5]. The steady state current limiting is easier to accomplish using average current mode control [6,7]. In this case, clamping the current command results in constant current operation under short-circuit or other overload conditions, while the instantaneous switch current protection can be added using an auxiliary peak-current comparator.…”

Section: Introductionmentioning

confidence: 99%

Overload protection in digitally controlled DC-DC converters

Hao

Maksimović

2006

2006 37th IEEE Power Electronics Specialists Conference

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This paper presents an approach to overload protection based on a predictive average current-mode control technique for digitally controlled DC-DC switched-mode power supplies. The proposed approach can be applied in voltage-mode or current-mode control architectures. The current limit, the converter actions upon detecting an overload, and the shape of the overload characteristic can be fully programmable. Static and dynamic operation are discussed and the results are verified on a digitally controlled 6V to 1.8 V, 10 A, 200 KHz synchronous buck prototype.

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Neuromusculotendinous Transfer

Cited by 19 publications

References 25 publications

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

Reconstruction Options for Lower Extremity Traumatic Wounds

Overload protection in digitally controlled DC-DC converters

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