title: Nerve Transfers for Persistent Traumatic Peroneal Nerve Palsy: The Inselspital Bern Experience.
abstract: BACKGROUND
  Patients in whom conventional peroneal nerve repair surgery failed to reconstitute useful foot lift need to be evaluated for their suitability to undergo a concomitant tendon transfer procedure or nerve transfers.
  
  
  OBJECTIVE
  To report our first clinical experience with nerve transfers for persistent traumatic peroneal nerve palsy.
  
  
  METHODS
  Between 2007 and 2013, 8 patients were operated on for foot drop after unsuccessful nerve surgery. Six patients without fatty degeneration of the anterior tibial muscle and proximal lesion of the peroneal nerve were oriented for tibial to peroneal nerve transfer. In the other 2 cases where the anterior and lateral compartments were destructed, the anterior tibial muscle function was reconstructed with a neurotized lateral gastrocnemius transfer. For each patient, we graded postoperative results using the British Medical Research Council scheme and the Ninkovic assessment scale.
  
  
  RESULTS
  Of the 6 patients who underwent nerve transfer of the anterior tibial muscle, 2 patients had excellent results, 1 patient had good results, 1 patient had fair results, and 2 patients had poor results. Of the 2 patients that underwent neurotized lateral gastrocnemius transfer, 1 patient achieved excellent results after tenolysis, whereas 1 patient achieved poor results. After the nerve transfer, 5 patients did not wear an ankle-foot orthosis. Four patients did not limp. Four patients were able to walk barefoot, navigate stairs, and participate in activities.
  
  
  CONCLUSIONS
  Early clinical results after tibial to peroneal nerve transfer and neurotized lateral gastrocnemius transfer appear mixed. The results of nerve transfer seem, on the whole, less reliable than the literature reports on tendon transfer.
authors.affiliation: Department of Plastic Surgery and Hand Surgery, INSELSPITAL Bern, University of Bern, Bern, Switzerland.
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.forename: Nicole
authors.initials: N
authors.lastname: Badur
authors.forename: Lukas
authors.initials: L
authors.lastname: Mathys
authors.forename: Esther
authors.initials: E
authors.lastname: Vögelin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D016067:Nerve Transfer / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D010543:Peroneal Nerve / Q000473:pathology / Q000601:surgery; D020427:Peroneal Neuropathies / Q000175:diagnosis* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013979:Tibial Nerve / Q000637:transplantation*; D055815:Young Adult