Neurotized lateral gastrocnemius muscle transfer for persistent traumatic peroneal nerve palsy: Surgical technique

Leclère, Franck-Marie; Badur, Nicole; Mathys, Lukas; Vögelin, Esther (2015). Neurotized lateral gastrocnemius muscle transfer for persistent traumatic peroneal nerve palsy: Surgical technique. Neurochirurgie, 61(4), pp. 292-297. Elsevier Masson SAS 10.1016/j.neuchi.2014.08.001

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INTRODUCTION Persistent traumatic peroneal nerve palsy, following nerve surgery failure, is usually treated by tendon transfer or more recently by tibial nerve transfer. However, when there is destruction of the tibial anterior muscle, an isolated nerve transfer is not possible. In this article, we present the key steps and surgical tips for the Ninkovic procedure including transposition of the neurotized lateral gastrocnemius muscle with the aim of restoring active voluntary dorsiflexion. SURGICAL TECHNIQUE The transposition of the lateral head of the gastrocnemius muscle to the tendons of the anterior tibial muscle group, with simultaneous transposition of the intact proximal end of the deep peroneal nerve to the tibial nerve of the gastrocnemius muscle by microsurgical neurorrhaphy is performed in one stage. It includes 10 key steps which are described in this article. Since 1994, three clinical series have highlighted the advantages of this technique. Functional and subjective results are discussed. We review the indications and limitations of the technique. CONCLUSION Early clinical results after neurotized lateral gastrocnemius muscle transfer appear excellent; however, they still need to be compared with conventional tendon transfer procedures. Clinical studies are likely to be conducted in this area largely due to the frequency of persistant peroneal nerve palsy and the limitations of functional options in cases of longstanding peripheral nerve palsy, anterior tibial muscle atrophy or destruction.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Handchirurgie
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery

UniBE Contributor:

Leclère, Franck-Marie; Badur, Nicole; Mathys, Lukas and Vögelin, Esther

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0028-3770

Publisher:

Elsevier Masson SAS

Language:

English

Submitter:

Veronika Picha

Date Deposited:

27 Jul 2015 15:22

Last Modified:

29 Feb 2016 14:08

Publisher DOI:

10.1016/j.neuchi.2014.08.001

PubMed ID:

26071175

Uncontrolled Keywords:

Nerve transfer; Neurotization; Lower limb; Peroneal nerve; Nerve injury; Foot drop; Gastrocnemius muscle transfer

BORIS DOI:

10.7892/boris.70381

URI:

https://boris.unibe.ch/id/eprint/70381

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