Treatment of peroneal nerve injuries with simultaneous tendon transfer and nerve exploration

Journal of Orthopaedic Surgery and Research

Anish R Kadakia³  Theodore A Kung²  Paul Cederna²  William Dahl¹  Daniel Fuchs³  George Ochenjele³  Paul J Switaj³  Zubair Khan¹  Bryant Ho³ 

[1] Department of Orthopaedic Surgery, University of Michigan, 2912 Taubman Center, 1500 E. Medical Center Dr, Ann Arbor 48109, MI, USA;Department of Plastic Surgery, University of Michigan, 2130 Taubman Center, 1500 E. Medical Center Dr, Ann Arbor 48109, MI, USA;Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair, Suite 1350, Chicago 60611, IL, USA

关键词: Tendon transfer;    Flexor digitorum longus;    Tibialis posterior;    Posterior tibialis;    Drop foot;    Foot drop;    Peroneal nerve injury;    Common peroneal nerve;    Peroneal nerve palsy;    Common peroneal nerve palsy;   

Others  :  1152342
DOI  :  10.1186/s13018-014-0067-6

 received in 2014-04-28, accepted in 2014-07-17,  发布年份 2014

【 摘 要 】

Background

Common peroneal nerve palsy leading to foot drop is difficult to manage and has historically been treated with extended bracing with expectant waiting for return of nerve function. Peroneal nerve exploration has traditionally been avoided except in cases of known traumatic or iatrogenic injury, with tendon transfers being performed in a delayed fashion after exhausting conservative treatment. We present a new strategy for management of foot drop with nerve exploration and concomitant tendon transfer.

Method

We retrospectively reviewed a series of 12 patients with peroneal nerve palsies that were treated with tendon transfer from 2005 to 2011. Of these patients, seven were treated with simultaneous peroneal nerve exploration and repair at the time of tendon transfer.

Results

Patients with both nerve repair and tendon transfer had superior functional results with active dorsiflexion in all patients, compared to dorsiflexion in 40% of patients treated with tendon transfers alone. Additionally, 57% of patients treated with nerve repair and tendon transfer were able to achieve enough function to return to running, compared to 20% in patients with tendon transfer alone. No patient had full return of native motor function resulting in excessive dorsiflexion strength.

Conclusion

The results of our limited case series for this rare condition indicate that simultaneous nerve repair and tendon transfer showed no detrimental results and may provide improved function over tendon transfer alone.

【 授权许可】

   
2014 Ho et al.; licensee BioMed Central Ltd.

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