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Nerve transfer in the spastic equino varus foot: Anatomical feasibility study
Constance Diner1, Laurent Mathieu2, Georges Pfister1
1Clinic of Orthopedics, Traumatology and Reconstructive Surgery, Percy Military Teaching Hospital, Clamart 92140, France.
Purpose:
We want to evaluate the feasibility of transferring a motor branch of the anterior tibial muscle (ATM) to the extensor digitorum longus (EDL) to evaluate this procedure in patients with spastic equinovarus foot (EVF) following post-stroke hemiplegia.
Methods:
Ten cadaveric dissections from five fresh frozen human cadavers were performed to establish the anatomic feasibility of transferring a motor branch of the deep peroneal nerve, usually destinated to the ATM, to the branch of the EDL to manage spastic EVF.
Results:
Six cases (60%) presented three branches destinated to the ATM, one case (10%) presented give branches, and three cases (30%) had four branches. In all specimens, the coaptation between the motor branch to the ATM, referred as the "effector" branch, and the branch of the EDL "receiver" branch was feasible without tension and did not require any intraneural dissection.
Conclusion:
This anatomical study confirms the feasibility of transferring a motor branch from the ATM to the EDL to correct a spastic EVF.
