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2026, Number 2

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Cir Plast 2026; 36 (2)

Use of tibial-to-deep peroneal nerve transfer and saphenous-to-sural nerve transfer for reconstruction in the lower extremity: a case report

Esquiliano-Raya R, Domínguez-Suárez C, Sánchez-Ramos R, Rivera RA, Canepa-Fernández P, Telich-Tarriba JE

Language: Spanish
References: 22
Page: 179-183
PDF size: 1325.31 Kb.


ABSTRACT

Nerve injuries in the lower extremities can be severely disabling due to impairment of motor and sensory functions. Traditional management is usually based on orthoses, tendon transfer or arthrodesis, with limited functional recovery. In recent years, nerve transfer techniques have emerged as a promising alternative to improve functional recovery. We present the case of a 39-year-old man with a complex sciatic nerve injury following multiple fractures of the femur, tibia and fibula. Despite initial osteosynthesis and physical therapy, he developed marked muscle atrophy, foot drop, anesthesia of the right leg, limited plantar flexion and absence of dorsiflexion. Electrodiagnostic evaluation showed complete conduction block in the deep and superficial peroneal nerves, with preserved tibial nerve function. Surgical treatment consisted of a double nerve transfer: a branch of the lateral gastrocnemius to the deep peroneal nerve for motor restoration and the saphenous to the sural nerve for sensory reinnervation. At six month follow-up, the patient showed significant functional recovery, including restoration of gait, recovery of active dorsiflexion and resolution of foot drop. He achieved independent ambulation without mobility aids and returned to work. Tibial-to-deep peroneal and saphenous-to-sural nerve transfers are an appropriate therapeutic option in patients with lower extremity nerve injuries.


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