1Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, USA
2Department of Foot and Ankle Surgery, Hospital for Special Surgery, USA
3Motion Analysis Laboratory, Hospital for Special Surgery, USA
4NYU Langone Health Department of Orthopedic Surgery, USA
*Corresponding author:Jona Kerluku, Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, USA
Submission: February 01, 2022; Published: April 14, 2022
ISSN: 2578-0069Volume2 Issue4
Introduction:Peroneal nerve injury resulting in foot drop is reported to occur in 14-40% of knee
dislocations, with severity ranging from neurapraxia to complete disruption. Operative interventions traditionally
considered for treatment include tendon transfer, nerve graft, or nerve transfer. Few reports
have presented comprehensive outcomes following combining these approaches. We report on functional
outcomes of two patients who underwent a combined nerve and tendon transfer for the treatment of
traumatic peroneal nerve palsy after multiligamentous knee injury.
Methods: Both presented with complete footdrop with sensory deficits after multiligamentous knee
injury with no signs of regeneration at <1 year by clinical and electrodiagnostic evaluation. Patients underwent
a combined nerve and tendon transfer with the same three Orthopaedic surgeons at a single
institution. Outcomes reported at least two-years from combined nerve and tendon transfer surgery include
physician reported measures, gait and strength analysis, and patient reported measures as compared
to the unaffected side.
Result: Both patients were able to return to activity without functional bracing. Three-dimensional
lower extremity kinematics during self-selected level walking demonstrated controlled ankle dorsiflexion
and plantarflexion throughout a minimum of five gait cycles, in addition to symmetrical knee and hip-flexion
in these combined nerve and tendon transfer patients. On hand-held dynamometry, inversion and
eversion remain weak for both patients.
Conclusion: Long-term functional recovery can be achieved after combined nerve and tendon transfer
in patients following traumatic peroneal nerve palsy after a multiligamentous knee injury.
Keywords: Reconstructive surgery; Nerve transfer; Tendon transfer; Foot drop; Deep peroneal nerve
Abbreviations:AFO: Ankle-Foot Orthosis; PTT: Posterior Tibial Tendon; FDL: Flexor Digitorum Longus; PTT: Posterior Tibial Tendon; FDL: Flexor Digitorum Longus; ROM: Range of Motion; MARS: Marx Activity Rating Scale