Clinical Outcomes of Nerve Transfers in Peroneal Nerve Palsy: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 35 (01) ◽  
pp. 057-065 ◽  
Author(s):  
Linden Head ◽  
Katie Hicks ◽  
Gerald Wolff ◽  
Kirsty Boyd
Keyword(s):  
Systematic Review ◽  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Meta Analysis ◽  
Nerve Transfer ◽  
Ankle Dorsiflexion ◽  
Peroneal Nerve Palsy ◽  
Time To Surgery ◽  
Nerve Transfers ◽  
The Mean

Background Given the unsatisfactory outcomes with traditional treatments, there is growing interest in nerve transfers to reestablish ankle dorsiflexion in peroneal nerve palsy. 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. Methods Methodology was registered with PROSPERO, and PRISMA guidelines were followed. MEDLINE, EMBASE, and the Cochrane Library were systematically searched. English studies investigating outcomes of nerve transfers in peroneal nerve palsy were included. Two reviewers completed screening and extraction. Methodological quality was evaluated with Newcastle-Ottawa Scale. Results Literature search identified 108 unique articles. Following screening, 14 full-text articles were reviewed. Four retrospective case series met inclusion criteria for meta-analysis. Overall, 41 patients underwent nerve transfer for peroneal nerve palsy. The mean age of the patients was 36.1 years, mean time to surgery was 6.3 months, and the mean follow-up period was 19.0 months. Donor nerve was either tibial (n = 36) or superficial peroneal branches/fascicles (n = 5). Recipient nerve was either deep peroneal (n = 24) or tibialis anterior branch (n = 17). Postoperative ankle dorsiflexion strength demonstrated a bimodal distribution with a mean Medical Research Council of 2.1. There were no significant differences in dorsiflexion strength between injury sites (p = 0.491), injury mechanisms (p = 0.125), donor (p = 0.066), or recipient nerves (p = 0.496). There were no significant correlations between dorsiflexion strength and patient age (p = 0.094) or time to surgery (p = 0.493). Conclusions There is variability in dorsiflexion strength following nerve transfer in peroneal nerve palsy, whereby there appear to be responders and non-responders. Further studies are needed to better define appropriate patient selection and the role of nerve transfers in the management of peroneal nerve palsy.

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.

A systematic review of peroneal nerve palsy and recovery following traumatic knee dislocation

2015 ◽  
Vol 23 (10) ◽  
pp. 2992-3002 ◽  
Author(s):  
Jarret M. Woodmass ◽  
Nicholas P. J. Romatowski ◽  
John G. Esposito ◽  
Nicholas G. H. Mohtadi ◽  
Peter D. Longino
Keyword(s):  
Systematic Review ◽  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Knee Dislocation ◽  
Peroneal Nerve Palsy

scholarly journals Immediate Nerve Transfer for the Treatment of Peroneal Nerve Palsy Secondary to an Intraneural Ganglion: Case Report and Review

2017 ◽  
Vol 25 (1) ◽  
pp. 54-58 ◽  
Author(s):  
I. Ratanshi ◽  
T. A. Clark ◽  
Jennifer L. Giuffre
Keyword(s):  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Ankle Dorsiflexion ◽  
Foot Drop ◽  
Peroneal Nerve Palsy ◽  
Intraneural Ganglion ◽  
Motor Branch ◽  
Ganglion Cysts ◽  
The Common

Intraneural ganglion cysts that occur within the common peroneal nerve are a rare cause of foot drop. The current standard of treatment for intraneural ganglion cysts involving the common peroneal nerve involves (1) cyst decompression and (2) ligation of the articular nerve branch to prevent recurrence. Nerve transfers are a time-dependent strategy for recovering ankle dorsiflexion in cases of high peroneal nerve palsy; however, this modality has not been performed for intraneural ganglion cysts involving the common peroneal nerve. We present a case of common peroneal nerve palsy secondary to an intraneural ganglion cyst occurring in a 74-year-old female. The patient presents with a 5-month history of pain in the right common peroneal nerve distribution and foot drop. The patient underwent simultaneous cyst decompression, articular nerve branch ligation, and nerve transfer of the motor branch to the flexor hallucis longus to a motor branch of the anterior tibialis muscle. At final follow-up, the patient demonstrated complete (M4+) return of ankle dorsiflexion, no pain, and no evidence of recurrence and was able to weight bare without the need of orthotic support. Given the minimal donor site morbidity and recovery of ankle dorsiflexion, this report underscores the importance of considering early nerve transfers in cases of high peroneal neuropathy due to an intraneural ganglion cyst.

scholarly journals Immediate Nerve Transfer for Treatment of Peroneal Nerve Palsy Secondary to an Intraneural Ganglion: Case Report and Review

2018 ◽  
Vol 26 (2) ◽  
pp. 80-84 ◽  
Author(s):  
Imran Ratanshi ◽  
Tod A. Clark ◽  
Jennifer L. Giuffre
Keyword(s):  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Ankle Dorsiflexion ◽  
Foot Drop ◽  
Peroneal Nerve Palsy ◽  
Intraneural Ganglion ◽  
Motor Branch ◽  
Ganglion Cysts ◽  
The Common

Intraneural ganglion cysts, which occur within the common peroneal nerve, are a rare cause of foot drop. The current standard of treatment for intraneural ganglion cysts involving the common peroneal nerve involves (1) cyst decompression and (2) ligation of the articular nerve branch to prevent recurrence. Nerve transfers are a time-dependent strategy for recovering ankle dorsiflexion in cases of high peroneal nerve palsy; however, this modality has not been performed for intraneural ganglion cysts involving the common peroneal nerve. We present a case of common peroneal nerve palsy secondary to an intraneural ganglion cyst occurring in a 74-year-old female. The patient presented with a 5-month history of pain in the right common peroneal nerve distribution and foot drop. The patient underwent simultaneous cyst decompression, articular nerve branch ligation, and nerve transfer of the motor branch to flexor hallucis longus to a motor branch of anterior tibialis muscle. At final follow-up, the patient demonstrated complete (M4+) return of ankle dorsiflexion, no pain, no evidence of recurrence and was able to bear weight without the need for orthotic support. Given the minimal donor site morbidity and recovery of ankle dorsiflexion, this report underscores the importance of considering early nerve transfers in cases of high peroneal neuropathy due to an intraneural ganglion cyst.

Common Peroneal Nerve Palsy After Grade I Inversion Ankle Sprain

2012 ◽  
Vol 21 (04) ◽  
pp. 261-265 ◽  
Author(s):  
Evanthia A. Mitsiokapa ◽  
Andreas F. Mavrogenis ◽  
Dimitris Antonopoulos ◽  
George Tzanos ◽  
Panayiotis J. Papagelopoulos
Keyword(s):  
Ankle Sprain ◽  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Palsy ◽  
Common Peroneal Nerve Palsy

scholarly journals Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822097914
Author(s):  
Lei Zhu ◽  
Jun-Wu Wang ◽  
Liang Zhang ◽  
Xin-Min Feng
Keyword(s):  
Systematic Review ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Perioperative Complications ◽  
Adult Spinal Deformity ◽  
Meta Analysis ◽  
Fusion Rate ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design: A systematic review and meta-analysis. Objectives: To evaluate clinical and radiographic outcomes, and perioperative complications of oblique lateral interbody fusion (OLIF) for adult spinal deformity (ASD). Methods: We performed a systematic review and meta-analysis of related studies reporting outcomes of OLIF for ASD. The clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry Disability Index (ODI). The radiographic parameters were evaluated by sagittal vertical axis (SVA), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence-lumbar lordosis (PI-LL), Cobb angle and fusion rate. A random effects model and 95% confidence intervals (CI) were performed to investigate the results. Results: A total of 16 studies involving 519 patients were included in the present study. The mean difference of VAS-back score, VAS-leg score and ODI score before and after surgery was 5.1, 5.0 and 32.3 respectively. The mean correction of LL was 20.6°, with an average of 6.9° per level and the mean correction of Cobb was 16.4°, with an average of 4.7° per level. The mean correction of SVA, PT, SS, TK and PI-LL was 59.3 mm, 11.7°, 6.9°, 9.4° and 20.6° respectively. The mean fusion rate was 94.1%. The incidence of intraoperative and postoperative complications was 4.9% and 29.6% respectively. Conclusions: OLIF is an effective and safe surgery method in the treatment of mild or moderate ASD and it has advantages in less intraoperative blood loss and lower perioperative complications.

Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽  
2021 ◽  
pp. 155894472098812
Author(s):  
J. Megan M. Patterson ◽  
Stephanie A. Russo ◽  
Madi El-Haj ◽  
Christine B. Novak ◽  
Susan E. Mackinnon
Keyword(s):  
Radial Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Nerve Transfer ◽  
Pinch Strength ◽  
Radial Nerve Palsy ◽  
Nerve Injuries ◽  
Tendon Transfers ◽  
Nerve Transfers ◽  
Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

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