title: Clinical results of transferring a motor branch of the tibial nerve to the deep peroneal nerve for treatment of foot drop.
abstract: BACKGROUND
  Foot drop is a very debilitating condition affecting patients' daily activities, and its treatment has been a challenge for neurosurgeons. Grafting the peroneal or sciatic nerve usually results in poor outcomes. Our previous anatomic study demonstrated the feasibility of transferring a motor branch of the tibial nerve to the deep peroneal nerve at the level of the popliteal fossa.
  
  
  OBJECTIVE
  To demonstrate the outcomes obtained after the transfer of a branch of the tibial nerve to the peroneal nerve for recovery of foot drop.
  
  
  METHODS
  A retrospective review of 13 patients with foot drop caused by injuries to a lumbar root or the sciatic or peroneal nerve, who underwent a transfer of the nerve of the soleus muscle to the deep peroneal nerve. The results were evaluated using the British Medical Research Council grading system.
  
  
  RESULTS
  Three patients were lost to follow-up. Of the remaining 10 patients, the outcomes were considered good (Medical Research Council grade M3 or M4) in 2 patients (20%) concerning ankle dorsiflexion and in 2 patients concerning toe extension (20%). One patient reported a reduced calf circumference.
  
  
  CONCLUSIONS
  The transfer of the nerve of the soleus muscle to the deep peroneal nerve demonstrated poor results in most of the patients, although favorable outcomes were observed in a few subjects. Due to the inconsistency of the results, we do not favor the routine use of this technique for the treatment of foot drop.
authors.affiliation: †Unit of Neurosurgery, Hospital de Base do Distrito Federal, Brasília, Distrito Federal, Brazil; ‡Hospital Santa Helena, Brasília, Distrito Federal, Brazil; §Peripheral Nerve Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Leandro Pretto
authors.initials: LP
authors.lastname: Flores
authors.forename: Roberto Sérgio
authors.initials: RS
authors.lastname: Martins
authors.forename: Mario Gilberto
authors.initials: MG
authors.lastname: Siqueira
mesh_terms: D000328:Adult; D005260:Female; D020233:Gait Disorders, Neurologic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D010543:Peroneal Nerve / Q000601:surgery*; D012189:Retrospective Studies; D013979:Tibial Nerve / Q000637:transplantation*; D016896:Treatment Outcome; D055815:Young Adult