Tibial nerve grafting for restoration of plantar sensation

Five patients with a segmental loss of the tibial nerve and insensate plantar aspect of the foot were evaluated at an average of 5 years (2.5-9.5) postsural nerve grafting of the tibial nerve. Free-tissue transfer was required in three patients. The results as graded by restoration of superficial sensation, healing of plantar ulceration, and absence of neurogenic pain were four good and one fair at follow-up over 2 years. Assessment at 2 years or less yielded one good and four poor results, indicating a prolonged recovery period. Nerve grafting may be indicated in segmental injuries of the tibial nerve to restore plantar sensation, but ultimate recovery may require up to 4 years.