Treatment of Peroneal Nerve Injury with Sural Nerve Transplantation; Case Report and Evaluation of Surgical Technique

Abstract

Objective: Peripheral nerve injury is encountered especially in extremity traumas. Treatment is often neglected as it may require allograft nerve transplantation. In cases of nerve damage developed especially on the surface of the extremity, sural nerve is usually the most frequently used graft.

Results: A 43-year-old male patient who developed right peroneal nerve injury six months ago following a penetrating stab wound, had 2/5 right foot dorsiflexion and total foot eversion weakness. EMG was compatible with total peroneal nerve total injury. The patient who underwent peroneal nerve repair with sural nerve graft at 6th month, and surgical technique will be discussed.

Methods: The region where the peroneal nerve injury had occurred was incised. The distal and proximal parts of the injury were carefully dissected. Distal and proximal part of the injured part was meticulously dissected and peronal nerve was exposed up to tibial muscle distally, and to the knee joint proximally.The area of the callus on both ends of the injury was excised. A sural nerve graft was planned to be taken after a 10-cm nerve defect was detected. Lateral to the right foot joint, and behind the outer malleolus, dissection was performed to remove the sural nerve. Approximately 10 cm of the graft material was removed and reimplanted to the peroneal nerve with 8.0 sutures.

Conclusion: There was a minimal improvement in neurological examination and significant findings in EMG at the sixth month of outpatient control of the patient. If peripheral nerve transplantation is done properly; it is a good method of improving the quality of life of the patient.