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J Reconstr Microsurg 1992; 8(3): 209-213
DOI: 10.1055/s-2007-1006702
ORIGINAL ARTICLE

© 1992 by Thieme Medical Publishers, Inc.

Functional Limb Salvage Combining Gastrocnemius Neurotization and Posterior Tibial Nerve Grafting: A Case Report

Thomas J. Francel, A. Lee Dellon
  • Division of Plastic Surgery, Washington University, Saint Louis, Missouri and Division of Plastic Surgery, Department of Neurological Surgery, Johns Hopkins Hospital, Baltimore, Maryland
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Publication History

Accepted for publication 1992

Publication Date:
08 March 2008 (online)

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ABSTRACT

Functional limb salvage requires motor and sensory reconstruction of the extremity. An avulsion of the tibial nerve in the popliteal fossa after arthroscopy is presented. Functional limb recovery necessitated intraoperative nerve mapping by awake stimulation, neurotization of the gastrocnemius muscle bellies, and interfascicular posterior tibial nerve grafting. Eighteen-month follow-up demonstrated good gastrocnemius motor function and protective sensation on the plantar surface. The patient is ambulatory without the need of an assistive device.