Nerve transfer in the spastic equino varus foot: Anatomical feasibility study |
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| Affiliation: | 1. Clinic of Orthopedics, Traumatology and Reconstructive Surgery, Percy Military Teaching Hospital, Clamart 92140, France;2. French Military Health Service Academy, Ecole du Val-de-Grâce, Paris 75005, France;3. Orthopedic Department, Raymond Poincaré Hospital, AP-HP, Garches, France;4. Centre Borelli, UMR 9010 Université Paris-Saclay, ENS Paris-Saclay, CNRS, French Military Health Service, F-94235, Cachan, France;1. Department of Orthopaedics and Traumatology, School of Medicine, Koc University, Istanbul, Turquie;2. Department of Neurology, School of Medicine, Koc University, Istanbul, Turquie;3. Department of Medical Genetics, School of Medicine, Koc University, Istanbul, Turquie;1. Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;2. Fukuoka University Faculty of Sports and Health Science, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;3. Department of Orthopedic Surgery, Nagasaki Prefecture Tsushima Hospital, 1168-7 Kechiotsu, Mitsushima-machi, Tsushima-shi, Nagasaki 817-0322, Japan;1. Department of Hand Surgery and Microsurgery, University of Modena and Reggio Emilia, Modena, Italy;2. Department of Hand Surgery, University of Verona, Verona, Italy;1. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sakarya University, Sakarya, Turkey;2. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sakarya University, Sakarya, Turkey;3. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Mehmet Akif Ersoy State Hospital, Canakkale, Turkey;4. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey |
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| Abstract: | PurposeWe want to evaluate the feasibility of transferring a motor branch of the anterior tibial muscle (ATM) to the extensor digitorum longus (EDL) to evaluate this procedure in patients with spastic equinovarus foot (EVF) following post-stroke hemiplegia.MethodsTen cadaveric dissections from five fresh frozen human cadavers were performed to establish the anatomic feasibility of transferring a motor branch of the deep peroneal nerve, usually destinated to the ATM, to the branch of the EDL to manage spastic EVF.ResultsSix cases (60%) presented three branches destinated to the ATM, one case (10%) presented give branches, and three cases (30%) had four branches. In all specimens, the coaptation between the motor branch to the ATM, referred as the “effector” branch, and the branch of the EDL “receiver” branch was feasible without tension and did not require any intraneural dissection.ConclusionThis anatomical study confirms the feasibility of transferring a motor branch from the ATM to the EDL to correct a spastic EVF. |
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| Keywords: | Nerve transfer Spasticity Equinovarus foot Anterior tibial muscle Extensor digitorum longus |
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