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J Reconstr Microsurg 2009; 25(3): 203-211
DOI: 10.1055/s-0028-1104548
© Thieme Medical Publishers

Interosseous Nerve Transfers for Tibialis Anterior Muscle Paralysis (Foot Drop): A Human Cadaver-Based Feasibility Study

Miguel A. Pirela-Cruz1 , Uel Hansen1 , Daniel A. Terreros2 , Alfred Rossum1 , Priscilla West1
  • 1Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas
  • 2Department of Pathology, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas
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Publication History

Publication Date:
01 December 2008 (online)

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ABSTRACT

This study explored the anatomical feasibility of using an interosseous nerve transfer (routed between the tibia and fibula) to restore motor function to the tibialis anterior (TA) muscle, following injury to the common peroneal nerve (resulting in a foot drop). The specific nerve branches evaluated as possible donor nerves included the nerves to the medial gastrocnemius, the lateral gastrocnemius, and the soleus muscles. All nerve transfers were accomplished using a direct interosseous route and a direct repair (one medial gastrocnemius transfer did require interpositional grafting). The distance from the repair site to the TA muscle was shortest for the transfer using the nerve branch to the soleus. Histologically, the nerve branch to the soleus was most similar to the branch to the TA for both axonal count and cross-sectional area. A two-incision surgical approach using a fibular window (mobilizing a fibular segment after double osteotomy) and interosseous routing of the transfer is proposed.

KEYWORDS

Foot drop - nerve transfer - tibialis anterior paralysis - soleus

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Miguel A Pirela-CruzM.D. 

Department of Orthopedic Surgery

4800 Alberta Avenue, El Paso, TX 79905

Email: Miguel.Cruz@ttuhsc.edu

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