Transfer of the lateral head of the gastrocnemius muscle for correction of drop-foot deformity after regenerated complete sciatic nerve injuries

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Abstract

Objectives

To evaluate the effectiveness of transfer of the lateral head of the gastrocnemius for treatment of drop-foot deformity after regenerated complete sciatic nerve injuries.

Patients and methods

The study included nine patients (one woman, eight men, mean age 30 years). The mean time delay between surgery on the sciatic nerve or trauma was 3 years (range, 2–6 years). Delay was necessary to allow for gastrocnemius±peroneal recovery after trauma, microsurgical reconstruction, or neurolysis or spontaneously. The lateral head of the gastrocnemius was harvested together with its longitudinal extension into the lateral tendoacilles; this complex was passed through the peroneal tendon and divided into two, a lateral half sutured to the extensor digitorum longus and extensor hallucis longus and a medial half sutured to the tibialis anterior tendon. The patients were assessed according to the Stanmore system questionnaire.

Results

According to the Stanmore assessment system, the results were poor in one foot, fair in two feet, good in four feet, and very good in four feet. The mean ankle dorsiflexion in patients was +6° (range, −5 to +10°). Claw-toe and drop-toe deformities were restored. No early complications were encountered apart from the complaints of two patients of the bulge because of tendon and suture material on the dorsum of the foot. There was no medial arch flattening or weakness in plantar flexion.

Conclusion

Transfer of the lateral head of the gastrocnemius for correction treatment of drop-foot deformity after regenerated complete sciatic nerve injuries is a valuable reconstructive option.

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