Chinese Journal of Clinical Anatomy >
The anatomical study of transfer of motor branches from proximal segment of the tibial nerve for treatment of high-level sciatic nerve injury
Received date: 2014-05-29
Online published: 2015-02-12
Objective To explore the feasibility of transfer of motor branches from the proximal tibial nerve to treat high-level sciatic nerve injuries in an anatomical study. Methods 30 sides of lower limbs from 15 embalmed adult cadavers were used to dissect and the motor branches from proximal tibial nerve were measured for following parameters, such as length, diameter, the location of original point relative to the level of the fibular head and the distance from original point to the fibular neck. Intraneural dissection the common peroneous nerve from the bifurcation to the proximal was performed to isolate the division of the deep and superficial peroneous division; the maximum length of intraneural dissection that could be dissected and the diameter of deep peroneous nerves were also measured. Results There were three main motor branches at the proximal leg: the branches destined to the lateral and medial heads of the gastrocnemius and to the soleus muscle. The length of these branches was (36.3±9.6) mm, (44.7±8.6) and (53.2±9.9)mm respectively. The maximum length of intraneural dissection of the common peroneous nerve was (59.3±7.2) mm. After dissection, branches to the soleus muscle and the lateral head of the gastrocnemius were adequate for direct nerve suture with the deep peroneous division in all cadavers without tension. And in 28 sides of lower limbs (93.3 percent), branches to the medial head of the gastrocnemius were adequate for nerve suture. Conclusion After intraneural dissection of the common fibular nerve, the motor branches from the proximal part of the tibial nerve can be harvested and transfered to restore the deep peroneous nerve in the treatment of high sciatic nerve injuries. Considering the length and diameter, branches to the soleus muscle were the best choice for the proposed transfer.
LI Meng-Heng , ZHONG Gong-Fa , CHEN Rong-Chun . The anatomical study of transfer of motor branches from proximal segment of the tibial nerve for treatment of high-level sciatic nerve injury [J]. Chinese Journal of Clinical Anatomy, 2015 , 33(1) : 5 -8 . DOI: 10.13418/j.issn.1001-165x.2015
[1] Kim DH, Murovic JA, Tiel R, et al. Management and outcomes in 353 surgically treated sciatic nerve lesions
[J]. J Neurosurg, 2004, 101(1):8-17.
[2] Gousheh J, Arasteh E, Beikpour H. Therapeutic results of sciatic nerve repair in Iran-Iraq war casualties
[J]. Plast Reconstr Surg, 2008, 121(3):878-886.
[3] Roganovic Z. Missile-caused complete lesions of the peroneal nerve and peroneal division of the sciatic nerve: results of 157 repairs
[J]. Neurosurgery, 2005, 57(6):1201-1212.
[4] Bodily KD, Spinner RJ, Bishop AT. Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: an anatomical study
[J]. Clin Anat, 2004,17(3):201-205.
[5] Gousheh J, Babaei A. A new surgical technique for the treatment of high common peroneal nerve palsy
[J]. Plast Reconstr Surg, 2002, 109(3):994-998.
[6] Nath RK, Lyons AB, Paizi M. Successful management of foot drop by nerve transfers to the deep peroneal nerve
[J]. J Reconstr Microsurg, 2008, 24(6):419-427.
[7] Hamdan FB, Jaffar AA, Ossi RG. The propensity of common peroneal nerve in thigh-level injuries
[J]. J Trauma, 2008, 64(2):300-303.
[8] Prasad AR, Steck JK, Dellon AL. Zone of traction injury of the common peroneal nerve
[J]. Ann Plast Surg, 2007, 59(3):302-306.
[9] Garozzo D, Ferraresi S, Buffatti P. Surgical treatment of common peroneal nerve injuries: indications and results. A series of 62 cases
[J]. J Neurosurg Sci, 2004, 48(3):105-112.
[10] 温广明，罗盛康，黄美贤，等. 选择性腓肠肌肌支切断小腿减肥术应用解剖
[J].中国临床解剖学杂志，2006, 24(6)：605-611.
[11]李明恒，张力成，陈维波，等. 胫神经肌支移位修复腓深神经的显微解剖
[J].中华显微外科杂志, 2011, 34(5):390-393.
[12]顾玉东. 健侧颈7移位20年
[J]. 中华手外科杂志, 2006, 22(4):193-194.
[13]Novak CB, Mackinnon SE. Distal anterior interosseous nerve transfer to the deep motor branch of the ulnar nerve for reconstruction of high ulnar nerve injuries
[J]. J Reconstr Microsurg, 2002, 18(6):459-464.
[14]Mackinnon SE, Roque B, Tung TH. Median to radial nerve transfer for treatment of radial nerve palsy.Case report
[J]. J Nerurosurg, 2007,107(3):666-671.
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