Use of superficial peroneal nerve graft for treating peripheral nerve injuries

This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point.

RESULTS:

The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking.

CONCLUSIONS:

Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.

Keywords:
Peripheral nerve; Nerve/transplantation; Peroneal neuropathies

Patient	Sex	Age (years)	Time elapsed since original injury (months)	Nerve affected
1	Male	19	9	Median and ulnar
2	Male	58	2	Ulnar
3	Male	39	7	Ulnar
4	Male	35	1	Median and ulnar
5	Male	36	4	Ulnar
6	Male	35	1	Median
7	Male	41	1	Median
8	Male	31	1	Ulnar
9	Male	35	1	Ulnar
10	Male	23	2	Median and ulnar
11	Male	30	3	Median

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author . E-mail: ribaksamuel@yahoo.com.br (S. Ribak).

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Use of superficial peroneal nerve graft for treating peripheral nerve injuries☆ ☆ Work developed in the Hand Surgery and Microsurgery Group, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil, and Hospital Nossa Senhora do Pari, São Paulo, SP, Brazil.

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Use of superficial peroneal nerve graft for treating peripheral nerve injuries^{^☆} ☆ Work developed in the Hand Surgery and Microsurgery Group, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil, and Hospital Nossa Senhora do Pari, São Paulo, SP, Brazil.