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Leandro Pretto Flores - One of the best experts on this subject based on the ideXlab platform.
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Proximal motor branches from the tibial Nerve as direct donors to restore function of the Deep Fibular Nerve for treatment of high sciatic Nerve injuries: a cadaveric feasibility study.
Neurosurgery, 2009Co-Authors: Leandro Pretto FloresAbstract:OBJECTIVE: The results of surgical repair of the Fibular division of the sciatic Nerve have been considered unsatisfactory, especially if grafts are necessary to reconstruct the Nerve. To consider the clinical application of the concept of distal Nerve transfer for the treatment of high sciatic Nerve injuries, this study aimed to determine detailed anatomic data about the possible donor branches from the tibial Nerve that are available for reinnervation of the Deep Fibular Nerve at the level of the popliteal fossa. METHODS: An anatomic study was performed that included the dissection of the popliteal fossa in 12 lower limbs of 6 formalin-fixed adult cadavers. It focused on the detailed anatomy of the tibial Nerve and its branches at the level of the proximal leg as well as the anatomy of the common Fibular Nerve and its largest divisions at the level of the neck of the fibula, i.e., the Deep and superficial Fibular Nerves. RESULTS: The branches of the tibial Nerve destined to the lateral and medial head of the gastrocnemius had a mean length of 43 mm and 35 mm, respectively. The branch to the posterior soleus muscle had a mean length of 65 mm. Intraneural dissection of the common Fibular Nerve, isolating its Deep and superficial Fibular divisions, was possible to a proximal mean distance of 71 mm. A tensionless direct suture to the Deep Fibular Nerve was made possible by using the Nerve to the lateral head of the gastrocnemius and the Nerve to the posterior soleus muscle in all specimens. Direct suture of the Nerve to the medial head of the gastrocnemius was possible in all cases except 1. CONCLUSION: The Nerve to the lateral and medial heads of the gastrocnemius and the Nerve to the posterior soleus muscle can be used as donors to restore function of the Deep Fibular Nerve in cases of high sciatic Nerve injury. However, proximal intraneural dissection of the Deep Fibular division of the common Fibular Nerve must also be performed. We recommend that the Nerve to the posterior soleus muscle should be the first choice for a donor in the proposed transfer.
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Proximal motor branches from the tibial Nerve as direct donors to restore function of the Deep Fibular Nerve for treatment of high sciatic Nerve injuries: a cadaveric feasibility study.
Neurosurgery, 2009Co-Authors: Leandro Pretto FloresAbstract:The results of surgical repair of the Fibular division of the sciatic Nerve have been considered unsatisfactory, especially if grafts are necessary to reconstruct the Nerve. To consider the clinical application of the concept of distal Nerve transfer for the treatment of high sciatic Nerve injuries, this study aimed to determine detailed anatomic data about the possible donor branches from the tibial Nerve that are available for reinnervation of the Deep Fibular Nerve at the level of the popliteal fossa. An anatomic study was performed that included the dissection of the popliteal fossa in 12 lower limbs of 6 formalin-fixed adult cadavers. It focused on the detailed anatomy of the tibial Nerve and its branches at the level of the proximal leg as well as the anatomy of the common Fibular Nerve and its largest divisions at the level of the neck of the fibula, i.e., the Deep and superficial Fibular Nerves. The branches of the tibial Nerve destined to the lateral and medial head of the gastrocnemius had a mean length of 43 mm and 35 mm, respectively. The branch to the posterior soleus muscle had a mean length of 65 mm. Intraneural dissection of the common Fibular Nerve, isolating its Deep and superficial Fibular divisions, was possible to a proximal mean distance of 71 mm. A tensionless direct suture to the Deep Fibular Nerve was made possible by using the Nerve to the lateral head of the gastrocnemius and the Nerve to the posterior soleus muscle in all specimens. Direct suture of the Nerve to the medial head of the gastrocnemius was possible in all cases except 1. The Nerve to the lateral and medial heads of the gastrocnemius and the Nerve to the posterior soleus muscle can be used as donors to restore function of the Deep Fibular Nerve in cases of high sciatic Nerve injury. However, proximal intraneural dissection of the Deep Fibular division of the common Fibular Nerve must also be performed. We recommend that the Nerve to the posterior soleus muscle should be the first choice for a donor in the proposed transfer.
P Cottias - One of the best experts on this subject based on the ideXlab platform.
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
2018Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made.Material and methods: We dissected ten fresh cadavers.Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming.Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography.Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously d...
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
Journal of Bone and Joint Surgery-british Volume, 2005Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made. Material and methods: We dissected ten fresh cadavers. Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming. Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography. Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously described.
Z Belkheyar - One of the best experts on this subject based on the ideXlab platform.
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
2018Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made.Material and methods: We dissected ten fresh cadavers.Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming.Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography.Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously d...
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
Journal of Bone and Joint Surgery-british Volume, 2005Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made. Material and methods: We dissected ten fresh cadavers. Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming. Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography. Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously described.
E Chavannes - One of the best experts on this subject based on the ideXlab platform.
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
2018Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made.Material and methods: We dissected ten fresh cadavers.Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming.Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography.Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously d...
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
Journal of Bone and Joint Surgery-british Volume, 2005Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made. Material and methods: We dissected ten fresh cadavers. Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming. Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography. Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously described.
A M Abou-chaaya - One of the best experts on this subject based on the ideXlab platform.
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
2018Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made.Material and methods: We dissected ten fresh cadavers.Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming.Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography.Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously d...
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INNERVATION OF THE GREAT TOE LONG EXTENSOR: ANATOMIC STUDY AND APPLICATION IN LEG FRACTURES
Journal of Bone and Joint Surgery-british Volume, 2005Co-Authors: Z Belkheyar, A M Abou-chaaya, A Oueslati, E Chavannes, P CottiasAbstract:Purpose: Isolated paralysis of the great toe long extensor is a rare complication of leg fractures. In certain patients, an erroneous diagnosis of compartment syndrome or muscle incarceration may be made. Material and methods: We dissected ten fresh cadavers. Results: The great toe long extensor was innervated by a branch of the Deep Fibular Nerve which arose 15 cm from the talocrural joint space and directly in contact with the periosteum of the tibial shaft. In this localisation, the branch can be directly sectioned during trauma, reduction, or reaming. Discussion: We had one patient aged 30 years with a fracture of the mid third of the leg who was treated by centromedullar nailing. Postoperatively, this patient developed isolated paralysis of the great toe long extensor. The isolated neurogenic origin of this paralysis was confirmed by electromyography. Conclusion: This case is illustrative of direct injury of the great toe long extensor innervation, a cause which to our knowledge has not been previously described.
