End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness
Background A proximal deep peroneal nerve (DPN) injury can significantly impact the functional capacity of the leg, to include compromised motor function of the tibialis anterior (TA) muscle. Clinical examination can range from weakness in ankle dorsiflexion, to complete foot drop. Diagnostic nerve...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2022-07-01
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| Series: | Journal of Reconstructive Microsurgery Open |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740979 |
| _version_ | 1797854682630062080 |
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| author | Edgardo R. Rodriguez-Collazo Asim A.Z. Raja Shawn Christopher Ward Stephanie Oexeman Arshad A. Khan |
| author_facet | Edgardo R. Rodriguez-Collazo Asim A.Z. Raja Shawn Christopher Ward Stephanie Oexeman Arshad A. Khan |
| author_sort | Edgardo R. Rodriguez-Collazo |
| collection | DOAJ |
| description | Background A proximal deep peroneal nerve (DPN) injury can significantly impact the functional capacity of the leg, to include compromised motor function of the tibialis anterior (TA) muscle. Clinical examination can range from weakness in ankle dorsiflexion, to complete foot drop. Diagnostic nerve conduction velocity (NCV) testing can demonstrate abnormalities at select areas of impingement (or) entrapment (i.e., regions affected by a demyelinating compression mono-neuropathy), along the proximal course of the common peroneal nerve.
Methods We retrospectively report on 17 patients with clinical weakness involving ankle dorsiflexion. All patients underwent surgical end-to-side anastomosis, transferring a muscular nerve branch from the superficial peroneal nerve (SPN) to a segment of the DPN responsible for TA muscle innervation. Outcomes were based on comparisons of preoperative and postoperative DPN motor function to the TA muscle, standardized to the British Medical Research Council Scale for Muscle Strength. Preoperative scores were generally M2 or below.
Results Postoperative outcome scores of M4 to M5 were considered good (or) successful. 94.1% of patients demonstrated successful outcomes.
Conclusion An end-to-side SPN motor branch anastomosis, into the motor branch of the DPN responsible for TA muscle innervation, can be a viable treatment option for weakness in ankle dorsiflexion. All reported cases involved a compromised segment of deep peroneal nerve within the proximal one-third of the leg. |
| first_indexed | 2024-04-09T20:11:09Z |
| format | Article |
| id | doaj.art-9a6ed4aa1b654b3e994ec8a48b979db6 |
| institution | Directory Open Access Journal |
| issn | 2377-0813 2377-0821 |
| language | English |
| last_indexed | 2024-04-09T20:11:09Z |
| publishDate | 2022-07-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Reconstructive Microsurgery Open |
| spelling | doaj.art-9a6ed4aa1b654b3e994ec8a48b979db62023-03-31T23:20:33ZengGeorg Thieme Verlag KGJournal of Reconstructive Microsurgery Open2377-08132377-08212022-07-010702e35e4310.1055/s-0041-1740979End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion WeaknessEdgardo R. Rodriguez-Collazo0Asim A.Z. Raja1Shawn Christopher Ward2Stephanie Oexeman3Arshad A. Khan4Department of Surgery, Amita Health Saint Joseph's Hospital, Chicago, IllinoisDepartment of Orthopedics and Rehabilitation, Womack Army Medical Center, Fort Bragg, North CarolinaDepartment of Surgery, Mercy Health Saint Rita's Medical Center Lima OH, Lima, OhioDepartment of Surgery, Amita Health Saint Joseph's Hospital, Chicago, IllinoisDepartment of Orthopedic Surgery, Indiana University School of Medicine, Gary/Northwest, IndianaBackground A proximal deep peroneal nerve (DPN) injury can significantly impact the functional capacity of the leg, to include compromised motor function of the tibialis anterior (TA) muscle. Clinical examination can range from weakness in ankle dorsiflexion, to complete foot drop. Diagnostic nerve conduction velocity (NCV) testing can demonstrate abnormalities at select areas of impingement (or) entrapment (i.e., regions affected by a demyelinating compression mono-neuropathy), along the proximal course of the common peroneal nerve. Methods We retrospectively report on 17 patients with clinical weakness involving ankle dorsiflexion. All patients underwent surgical end-to-side anastomosis, transferring a muscular nerve branch from the superficial peroneal nerve (SPN) to a segment of the DPN responsible for TA muscle innervation. Outcomes were based on comparisons of preoperative and postoperative DPN motor function to the TA muscle, standardized to the British Medical Research Council Scale for Muscle Strength. Preoperative scores were generally M2 or below. Results Postoperative outcome scores of M4 to M5 were considered good (or) successful. 94.1% of patients demonstrated successful outcomes. Conclusion An end-to-side SPN motor branch anastomosis, into the motor branch of the DPN responsible for TA muscle innervation, can be a viable treatment option for weakness in ankle dorsiflexion. All reported cases involved a compromised segment of deep peroneal nerve within the proximal one-third of the leg.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740979weaknessankle dorsiflexiondeep peroneal nerve |
| spellingShingle | Edgardo R. Rodriguez-Collazo Asim A.Z. Raja Shawn Christopher Ward Stephanie Oexeman Arshad A. Khan End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness Journal of Reconstructive Microsurgery Open weakness ankle dorsiflexion deep peroneal nerve |
| title | End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness |
| title_full | End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness |
| title_fullStr | End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness |
| title_full_unstemmed | End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness |
| title_short | End-to-Side Nerve Transfer for the Management of Chronic Leg Compartment Ankle Dorsiflexion Weakness |
| title_sort | end to side nerve transfer for the management of chronic leg compartment ankle dorsiflexion weakness |
| topic | weakness ankle dorsiflexion deep peroneal nerve |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740979 |
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