Skip to main content
SpringerLink
Log in

Translocation of the soleus muscular branch of the tibial nerve to repair high common peroneal nerve injury

  • Original Article - Peripheral Nerves
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

This study was performed to evaluate the clinical effect of translocating the soleus muscular branch of the tibial nerve to repair the deep peroneal nerve.

Methods

Eight patients were treated for high common peroneal nerve injury. The deep peroneal nerve was separated out from the common peroneal nerve if no injury occurred upon opening the epineurium of the common peroneal nerve. The soleus muscular branch of the tibial nerve was then translocated to the deep peroneal nerve.

Results

The average follow-up duration was 21.75 months. Electromyography revealed newly appearing electric potentials in the tibialis anterior, extensor hallucis longus, and extensor toe longus muscle at 8 to 10 months postoperatively. Four patients showed good functional recovery after surgery; functional recovery was poor in other patients.

Conclusions

Translocation of the soleus muscle branch is a feasible method to treat high common peroneal nerve injuries. A full understanding of the indications for this operation is required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bertelli JA (2015) Transfer of the radial nerve branch to the extensor carpi radialis brevis to the anterior interosseous nerve to reconstruct thumb and finger flexion. J Hand Surg [Am] 40:323–328

    Article  Google Scholar 

  2. Bodily KD, Spinner RJ, Bishop AT (2010) Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: an anatomical study. Clin Anat 17:201–205

    Article  Google Scholar 

  3. Cai Y, Hou C (2015) A feasibility study on transposition of proximal motor branch from tibial nerve to reconstruct deep fibular nerve. Chin Reparat Reconstruct Surg 29:58–62 [Article in Chinese]

    Google Scholar 

  4. Chen HH, Zong HY, Meng DP, Cai YW, Hou CL, Lin HD (2018) Experimental study on repairmen of high deep peroneal nerve injury by nerve transposition methods using different proximal tibial nerve muscular branches. Chin J Microsurg 41:57–61 [Article in Chinese]

    Google Scholar 

  5. Cho BK, Park KJ, Choi SM, Im SH, SooHoo NF (2017) Functional outcomes following anterior transfer of the tibialis posterior tendon for foot drop secondary to nerve palsy. Foot Ankle Int 38:627–633

    Article  PubMed  Google Scholar 

  6. Chotigavanich C (1990) Tendon transfer for radial nerve palsy. Bull Hosp Jt Dis Orthop Inst 50:1–10

    CAS  PubMed  Google Scholar 

  7. Cornwall R, Radomisli TE (2000) Nerve injury in traumatic dislocation of the hip. Clin Orthop Relat Res 377:84–91

    Article  Google Scholar 

  8. de Bruijn IL, Geertzen JH, Dijkstra PU (2007) Functional outcome after peroneal nerve injury. Int J Rehabil Res 30:333–337

    Article  PubMed  Google Scholar 

  9. Flores LP (2009) Proximal motor branches from the tibial nerve as direct donors to restore function of the deep fibular nerve for treatment of high sciatic nerve injuries: a cadaveric feasibility study. Neurosurgery 65:218–224

    Article  PubMed  Google Scholar 

  10. Flores LP, Martins RS, Siqueira MG (2013) Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop. Neurosurgery 73:615–616

    Google Scholar 

  11. Forli A, Bouyer M, Aribert M, Curvale C, Delord M, Corcella D, Moutet F (2017) Upper limb nerve transfers: a review. Hand Surg Rehabil 36:151–172

    Article  CAS  PubMed  Google Scholar 

  12. George SC, Boyce DE (2014) An evidence-based structured review to assess the results of common peroneal nerve repair. Plast Reconstr Surg 134:302e–311e

    Article  CAS  PubMed  Google Scholar 

  13. Giuffre JL, Bishop AT, Spinner RJ, Levy BA, Shin AY (2012) Partial tibial nerve transfer to the tibialis anterior motor branch to treat peroneal nerve injury after knee trauma. Clin Orthop Relat Res 470:779–790

    Article  PubMed  Google Scholar 

  14. Gousheh J, Babaei A (2002) A new surgical technique for the treatment of high common peroneal nerve palsy. Plast Reconstr Surg 109:994–998

    Article  PubMed  Google Scholar 

  15. Hamdan FB, Jaffar AA, Ossi RG (2008) The propensity of common peroneal nerve in thigh-level injuries. Trauma 64:300–303

    Article  Google Scholar 

  16. Hohmann E, Wansbrough G, Senewiratne S, Tetsworth K (2016) Medial gastrocnemius flap for reconstruction of the extensor mechanism of the knee following high-energy trauma. Minimum 5 year follow-up. Injury 47:1750–1755

    Article  PubMed  Google Scholar 

  17. Houschyar KS, Momeni A, Pyles MN, Cha JY, Maan ZN, Duscher D, Jew OS, Siemers F, van Schoonhoven J (2016) The role of current techniques and concepts in peripheral nerve repair. Plast Surg Int 2016:4175293

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Kim DH, Murovic JA, Tiel R, Kline DG (2004) Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg 101:8–17

    Article  PubMed  Google Scholar 

  19. Kline DG, Kim D, Midha R, Harsh C, Tiel R (1998) Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurg 89:13–23

    Article  CAS  PubMed  Google Scholar 

  20. Leclère FM, Badur N, Mathys L, Vögelin E (2015) Nerve transfers for persistent traumatic peroneal nerve palsy: the Inselspital Bern experience. Neurosurgery 77:572–580

    Article  PubMed  Google Scholar 

  21. Mackinnon SE (2016) Donor distal, recipient proximal and other personal perspectives on nerve transfers. Hand Clin 32:141–151

    Article  PubMed  Google Scholar 

  22. Mackinnon SE, Colbert SH (2008) Nerve transfers in the hand and upper extremity surgery. Tech Hand Up Extrem Surg 12:20–33

    Article  PubMed  Google Scholar 

  23. Millesi H (2007) Surgery on muscles in consequence of peripheral nerve lesions. Acta Neurochir Suppl 100:179–181

    Article  CAS  PubMed  Google Scholar 

  24. Mohanty CB, Bhat D, Devi BI (2015) Role of central plasticity in the outcome of peripheral nerve regeneration. Neurosurgery 77:418–423

    Article  PubMed  Google Scholar 

  25. Molund M, Engebretsen L, Hvaal K, Hellesnes J, Ellingsen Husebye E (2014) Posterior tibial tendon transfer improves function for foot drop after knee dislocation. Clin Orthop Relat Res 472:2637–2643

    Article  PubMed  PubMed Central  Google Scholar 

  26. Movahedi Yeganeh M (2016) Triple tendon transfer for correction of foot deformity in common peroneal nerve palsy. Foot Ankle Int 37:665–669

    Article  PubMed  Google Scholar 

  27. Nath RK, Somasundaram C (2017) Gait improvements after peroneal or tibial nerve transfer in patients with foot drop: a retrospective study. Eplasty 17:e31

    PubMed  PubMed Central  Google Scholar 

  28. Nath RK, Lyons AB, Paizi M (2008) Successful management of foot drop by nerve transfers to the deep peroneal nerve. J Reconstr Microsurg 24:419–427

    Article  PubMed  Google Scholar 

  29. Park JW, Lee YS, Oh JK, Park JH, Lee JW, Park JS (2009) Knee extensor mechanism reconstruction with an extended gastrocnemius flap and a saphenous neurocutaneous flap. Orthop Trauma 23:309–12g

    CAS  Google Scholar 

  30. Rhomberg M, Schwabegger AH, Ninkovic M, Bauer T, Ninkovic M (2000) Gastrocnemius myotendinous flap for patellar or quadriceps tendon repair, or both. Clin Orthop Relat Res:152–160

  31. Richard BM (1989) Interosseous transfer of tibialis posterior for common peroneal nerve palsy. J Bone Joint Surg (Br) 71:834–837

    Article  CAS  Google Scholar 

  32. Socolovsky M, Malessy M, Lopez D, Guedes F, Flores L (2017) Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus 42:E13

    Article  PubMed  Google Scholar 

  33. Steinau HU, Tofaute A, Huellmann K, Goertz O, Lehnhardt M, Kammler J, Steinstraesser L, Daigeler A (2011) Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements. Arch Orthop Trauma Surg 131:903–910

    Article  PubMed  Google Scholar 

  34. Vloka JD, Hadzić A, Lesser JB (1997) A common epineural sheath for the nerves in the popliteal fossa and its possible implications for sciatic nerve block. Anesth Analg 9:387–390

    Article  Google Scholar 

Download references

Funding

This study was supported by the Key Project of the Health and family Planning Commission of shanghai (grant number 201440510) and the Project of Research doctor of Changzheng Hospital (grant number 201712).

Author information

Author notes

  1. Huihao Chen and Depeng Meng contributed equally to the manuscript and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People’s Republic of China

    Huihao Chen, Depeng Meng & Chunlin Hou

  2. Department of Orthopedic Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Haining Road 100, Shanghai, 200080, People’s Republic of China

    Gang Yin & Haodong Lin

Authors
  1. Huihao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Depeng Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gang Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chunlin Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haodong Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haodong Lin.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Guilan University of Medical Sciences) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patients.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Comments

This article describes a technique using a nerve transfer using a tibial branch to the soleus muscle to restore peroneal nerve function mediating the important function of foot dorsiflexion. This transfer is particularly useful in the setting of proximal peroneal nerve injuries where tribal nerve function is 5/5. Although such a transfer involves activating antagonistic muscles in terms of function, over time the patient learns to selectively activate the muscles so as to produce useful foot dorsiflexion. This technique is another useful addition to the peripheral nerve’s toolkit box.

Michel Kliot

California, USA

This article is part of the Topical Collection on Peripheral Nerves

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, H., Meng, D., Yin, G. et al. Translocation of the soleus muscular branch of the tibial nerve to repair high common peroneal nerve injury. Acta Neurochir 161, 271–277 (2019). https://doi.org/10.1007/s00701-018-03797-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-018-03797-x

Keywords

Search

Navigation