Brachial Plexus and Peripheral Nerve Injury Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
J Clin Neurosci. 2020 Aug;78:159-163. doi: 10.1016/j.jocn.2020.04.086. Epub 2020 Apr 24.
Different mechanisms including knee dislocation, replacement surgery, nerve tumor, lumbar disc herniation, sharp injury, and gunshot wound lead to foot drop. Several surgical techniques have been used for treatment of foot drop, however, they have had sub-optimal outcomes. Soleus branch of tibial nerve is a good donor for nerve transfer for treatment of foot drop. In this is retrospective study, we reviewed medical records of 6 consecutive patients with sustained foot drop following injury to lumbar root or peroneal nerve, who underwent transfer of the soleus branch of tibial nerve to deep peroneal nerve during 2014-2016. The mean age of the patients was 44.8 years and duration of injury to surgery and follow-up was 8.3 and 14.6 months, respectively. At the end of the follow-up, ankle dorsiflexion force was M4 in two patients (with traumatic peroneal nerve injury with M3 toe extension) and was M2 in one patient. There were three patients with lumbar degenerative disease. Of these patients, two showed M0 and one patient experienced M1 ankle dorsiflexion. We recommend that transfer of soleus nerve to deep peroneal nerve is used as an alternative technique for treatment of foot drop.
导致足下垂的原因包括膝关节脱位、置换手术、神经肿瘤、腰椎间盘突出症、锐器伤和枪伤。有几种手术技术已被用于治疗足下垂，但效果并不理想。胫神经比目鱼肌支是治疗足下垂的神经转移的良好供体。在这项回顾性研究中，我们回顾了 2014 年至 2016 年间，6 例因腰椎神经根或腓总神经损伤后持续足下垂的患者的病历，这些患者接受了比目鱼肌支胫神经转移至腓深神经的手术。患者的平均年龄为 44.8 岁，损伤至手术和随访的时间分别为 8.3 个月和 14.6 个月。在随访结束时，2 名患者（外伤性腓总神经损伤伴 M3 趾伸肌）的踝关节背屈力为 M4，1 名患者为 M2。其中 3 例患者患有腰椎退行性疾病。这些患者中，2 例为 M0，1 例患者踝关节背屈为 M1。我们建议将比目鱼肌支胫神经转移到腓深神经作为治疗足下垂的一种替代技术。
