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A successful case of sural nerve cable grafting after a gunshot wound to the knees
Achal Khanna1, Ravi Mahajani, Timothy Proudman
1Department of Surgery, Queen Elizabeth Hospital, University of Adelaide, Australia. khannaachal@hotmail.com
Objective:
To describe a successful case of sural nerve cable grafting to the leg following a gunshot injury.
Clinical Presentation And Intervention:
A 28-year-old man was shot at close range, sustaining extensive damage to the left popliteal fossa. Initial exploratory operation revealed a pierced sciatic nerve proximal to its bifurcation into the tibial and common peroneal branches. The 60% division 3.5-cm common peroneal deficit and the complete transection of the tibial division were repaired using an ipsilateral sural cable nerve graft that was not reversed. Initial re-assessment in the clinic setting revealed a denervation atrophy of all 3 leg compartments and paraesthesia below the left knee sparing the sural nerve. After 3 months, the patient had a significant improvement in both power and sensation which was felt to be due to a resolution of a neuropraxic component to the nerve injury. Re-assessment at 9 months and later at 14 months revealed an almost full recovery, suggestive of the success of the nerve grafting procedure.
Conclusion:
This report shows that, given favourable conditions, a good result is possible following use of cable nerve grafting to treat nerve damage from gunshot.
