On “Successful Management of Foot Drop by Nerve Transfers to the Deep Peroneal Nerve” (J Reconstr Microsurg 2008;24:419–428)

2010 ◽  
Vol 26 (06) ◽  
pp. 425-426 ◽  
Author(s):  
Ramin Ipaktchi ◽  
Christine Radtke ◽  
Matthias Aust ◽  
Marc Busche ◽  
Peter Vogt
Keyword(s):  
Peroneal Nerve ◽  
Foot Drop ◽  
Deep Peroneal Nerve ◽  
Successful Management ◽  
Nerve Transfers

scholarly journals Clinical Results of Transferring a Motor Branch of the Tibial Nerve to the Deep Peroneal Nerve for Treatment of Foot Drop

Neurosurgery ◽  
2013 ◽  
Vol 73 (4) ◽  
pp. 609-616 ◽  
Author(s):  
Leandro Pretto Flores ◽  
Roberto Sérgio Martins ◽  
Mario Gilberto Siqueira
Keyword(s):  
Medical Research ◽  
Soleus Muscle ◽  
Peroneal Nerve ◽  
Research Council ◽  
Medical Research Council ◽  
Tibial Nerve ◽  
Foot Drop ◽  
Deep Peroneal Nerve ◽  
Motor Branch ◽  
Patient Reported

Abstract BACKGROUND: Foot drop is a very debilitating condition affecting patients' daily activities, and its treatment has been a challenge for neurosurgeons. Grafting the peroneal or sciatic nerve usually results in poor outcomes. Our previous anatomic study demonstrated the feasibility of transferring a motor branch of the tibial nerve to the deep peroneal nerve at the level of the popliteal fossa. OBJECTIVE: To demonstrate the outcomes obtained after the transfer of a branch of the tibial nerve to the peroneal nerve for recovery of foot drop. METHODS: A retrospective review of 13 patients with foot drop caused by injuries to a lumbar root or the sciatic or peroneal nerve, who underwent a transfer of the nerve of the soleus muscle to the deep peroneal nerve. The results were evaluated using the British Medical Research Council grading system. RESULTS: Three patients were lost to follow-up. Of the remaining 10 patients, the outcomes were considered good (Medical Research Council grade M3 or M4) in 2 patients (20%) concerning ankle dorsiflexion and in 2 patients concerning toe extension (20%). One patient reported a reduced calf circumference. CONCLUSION: The transfer of the nerve of the soleus muscle to the deep peroneal nerve demonstrated poor results in most of the patients, although favorable outcomes were observed in a few subjects. Due to the inconsistency of the results, we do not favor the routine use of this technique for the treatment of foot drop.

scholarly journals Peroneal nerve decompression

2018 ◽  
Vol 44 (videosuppl1) ◽  
pp. V6 ◽  
Author(s):  
Mark Corriveau ◽  
Jacob D. Lescher ◽  
Amgad S. Hanna
Keyword(s):  
Peroneal Nerve ◽  
Foot Drop ◽  
Superficial Peroneal Nerve ◽  
Fibular Head ◽  
Deep Peroneal Nerve ◽  
Operative Techniques ◽  
Key Steps ◽  
Adequate Decompression ◽  
Nerve Release ◽  
Fibular Nerve

Peroneal neuropathy is a common pathology encountered by neurosurgeons. Symptoms include pain, numbness, and foot drop. When secondary to compression of the nerve at the fibular head, peroneal (fibular) nerve release is a low-risk procedure that can provide excellent results with pain relief and return of function. In this video, the authors highlight key operative techniques to ensure adequate decompression of the nerve while protecting the 3 major branches, including the superficial peroneal nerve, deep peroneal nerve, and recurrent genicular (articular) branches. Key steps include positioning, circumferential nerve dissection, fascial opening, isolation of the major branches, and closure.The video can be found here: https://youtu.be/0y9oE8w1FIU.

Soleus nerve transfer to deep peroneal nerve for treatment of foot drop

2020 ◽  
Vol 78 ◽  
pp. 159-163 ◽  
Author(s):  
Mohammadreza Emamhadi ◽  
Amin Naseri ◽  
Iraj Aghaei ◽  
Morteza Ashrafi ◽  
Roxana Emamhadi ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Nerve Transfer ◽  
Foot Drop ◽  
Deep Peroneal Nerve

scholarly journals Deep Peroneal Nerve Palsy Caused by an Extraneural Ganglion Cyst: A Rare Case

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios Nikolopoulos ◽  
George Safos ◽  
Neoptolemos Sergides ◽  
Petros Safos
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Peripheral Neuropathies ◽  
Tibiofibular Syndesmosis ◽  
Deep Peroneal Nerve ◽  
Intraneural Ganglion ◽  
Ganglion Cysts ◽  
The Common

Lower extremities peripheral neuropathies caused by ganglion cysts are rare. The most frequent location of occurrence is the common peroneal nerve and its branches, at the level of the fibular neck. We report the case of a 57-year-old patient admitted with foot drop, due to an extraneural ganglion of the upper tibiofibular syndesmosis, compressing the deep branch of the peroneal nerve. Although there have been many previous reports of intraneural ganglion involvement with the lower limb nerves, to our knowledge, this is the second reported occurrence of an extraneural ganglion distinctly localized to the upper tibiofibular syndesmosis and palsying deep peroneal nerve. The diagnosis was made preoperatively using MRI. The common peroneal nerve and its branches were recognized and traced to its bifurcation during the operation, and the ganglion cyst was removed. Two months after surgery, the patient was pain-free and asymptomatic except for cutaneous anesthesia in the distribution of the deep peroneal nerve.

Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy

Neurosurgery ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 572-580 ◽  
Author(s):  
Franck Marie Leclère ◽  
Nicole Badur ◽  
Lukas Mathys ◽  
Esther Vögelin
Keyword(s):  
Peroneal Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Nerve Transfer ◽  
Foot Drop ◽  
Peroneal Nerve Palsy ◽  
Lateral Gastrocnemius ◽  
Anterior Tibial Muscle ◽  
Nerve Transfers ◽  
Anterior Tibial

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.

Foot Reanimation Using Double Nerve Transfer to Deep Peroneal Nerve: A Novel Technique for Treatment of Neurologic Foot Drop

2021 ◽  
pp. 107110072199779
Author(s):  
Mohamed El-Taher ◽  
Asser Sallam ◽  
Mohamed Saleh ◽  
Ahmed Metwally
Keyword(s):  
Peroneal Nerve ◽  
Pain Perception ◽  
Nerve Transfer ◽  
High Energy ◽  
Primary Objective ◽  
Motor Recovery ◽  
Foot Drop ◽  
Deep Peroneal Nerve ◽  
Level Of Evidence ◽  
Ankle Motion

Background: Our primary objective was to assess the efficacy of a new technique for foot reanimation in patients with neurologic foot drop using double nerve transfer from the tibial to the deep peroneal nerve. Our secondary objective was to document the technical nuances of our technique. Methods: Thirty-one patients with common peroneal nerve injury between October 2015 and March 2019 were prospectively enrolled in the study. Patients underwent a transfer of the tibial nerve branches to flexor digitorum longus and lateral head of gastrocnemius to the deep peroneal nerve. Motor recovery, range of ankle dorsiflexion, pain, leg girth, and complications were examined as outcome measures. The modified Medical Research Council (MRC) scale was adopted to assess the motor power recovery. All patients were followed up for a minimum of 1 year. Results: Motor recovery of M3 or M4 grade of tibialis anterior, extensor hallucis longus, and extensor digitorum longus was achieved in 15 of 31, 13 of 31, and 12 of 31 patients, respectively. Those patients could discontinue use of orthosis. Most patients with high-energy traumas or knee-level injuries failed to recover antigravity function. Only 2 patients reported weak postoperative toe plantarflexion. Our patients achieved significant improvement of the pain perception and range of active ankle motion at the final follow-up. Conclusion: The double nerve transfer technique represented a feasible and safe surgical option. It has been shown to improve function in some patients with neurologic foot drop resulting from a less than 12-month injury of the deep peroneal nerve. Level of Evidence: Level IV, therapeutic.

scholarly journals Drop Foot Secondary to a Peroneal Intraneural Ganglion Connected to the Superior Tibiofibular Joint: A Case Report

2020 ◽  
Author(s):  
Kenan Kıbıcı ◽  
Berrin Erok ◽  
Akın Onat
Keyword(s):  
Peroneal Nerve ◽  
Imaging Modality ◽  
Axonal Neuropathy ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Intraneural Ganglion ◽  
Articular Branch ◽  
Ankle Eversion ◽  
Adjacent Structures ◽  
Tibiofibular Joint

AbstractPeroneal neuropathy is the most frequent mononeuropathy of the lower extremity. Intraneural ganglion cysts (INGCs) are among rare causes of peroneal nerve palsy. According to the articular (synovial) theory, the articular branch plays the key role in the pathogenesis. Patients present with pain around the fibular head and neck, motor weakness resulting in foot drop and paresthesia in the anterolateral calf and foot. Ultrasonography (US) and MRI are both useful in the diagnosis, but MRI is the best imaging modality in the demonstration of the articular connection and the relation of the cyst with adjacent structures, even without special neurography sequences. We present a 32-year-old male patient referred to our neurosurgery clinic with suspicion of lumbar radiculopathy. He presented with right foot drop which began 3 weeks prior. On examination, there was 90% loss in the ankle dorsiflexion and finger extension. Ankle eversion was also weakened. There was no low back or posterolateral thigh pain to suggest L5 radiculopathy and sciatic neuropathy. Following negative lumbar spine MRI, peripheral neuropathy was concerned. Electrodiagnostic evaluations findings were consistent with acute/subacute common peroneal nerve (CPN) axonal neuropathy. Subsequent MRI of knee showed a homogeneous, thin-walled tubular cystic lesion, extending along the course of the CPN and its articular branch. Full recovery of the neuropathy was achieved with early diagnosis and decompression via microsurgical epineurotomy. The diagnosis of INGC was confirmed by histopathologic examination. INGCs, although rare, should also be considered in the differential diagnosis of peripheral mononeuropathies.

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