Download PDF
CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(06): 769-772
DOI: 10.1055/s-0042-1756290
Extremity/Lymphedema
Idea and Innovation

Application of Supercharge End-to-Side (SETS) Obturator to Femoral Nerve Transfer in Electrical Injury-Induced Neuropathy to Improve Knee Extension

Katie Pei-Hsuan Wu‡   *
1   Department of Physical Medicine and Rehabilitation, Chang Gung Medical University, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
,
Li-Ching Lin‡   *
2   Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Medical University, Chang Gung Memorial Hospital, Linkou, Taiwan
,
Johnny Chuieng-Yi Lu 
2   Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Medical University, Chang Gung Memorial Hospital, Linkou, Taiwan
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.

Keywords

supercharge - femoral nerve - end to side nerve transfer - obturator to femoral nerve - electrical injury

Note

All figures provided in this manuscript are original diagrams drawn by the authors and not published elsewhere.


Patient Consent

The patient has granted written consent for use of their photos and video for publication.


Authors' Contributions

Wu K.P.H. revised and completed the entire manuscript. Also involved in further edits and revisions. Lin L.C. reviewed the patient profile and provided the first draft. Lu J.C.Y. provided the case and provided the final edits as the corresponding author.


Ethical Approval

This publication was approved by the Institutional Review Board at the Chang Gung Medical Foundation under the file number 202100759B0.


* The first two authors contributed equally to the article.




Publication History

Received: 08 December 2021

Accepted: 17 February 2022

Article published online:
13 December 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Koumbourlis AC. Electrical injuries. Crit Care Med 2002; 30 (suppl 11): S424-S430
    CrossrefPubMedGoogle Scholar
  • 2 Duff K, McCaffrey RJ. Electrical injury and lightning injury: a review of their mechanisms and neuropsychological, psychiatric, and neurological sequelae. Neuropsychol Rev 2001; 11 (02) 101-116
    CrossrefPubMedGoogle Scholar
  • 3 Campbell AA, Eckhauser FE, Belzberg A, Campbell JN. Obturator nerve transfer as an option for femoral nerve repair: case report. Neurosurgery 2010;66(suppl operative 6):375, discussion 375
    Google Scholar
  • 4 Tung TH, Chao A, Moore AM. Obturator nerve transfer for femoral nerve reconstruction: anatomic study and clinical application. Plast Reconstr Surg 2012; 130 (05) 1066-1074
    CrossrefPubMedGoogle Scholar
  • 5 Fleuren JF, Voerman GE, Snoek GJ, Nene AV, Rietman JS, Hermens HJ. Perception of lower limb spasticity in patients with spinal cord injury. Spinal Cord 2009; 47 (05) 396-400
    CrossrefPubMedGoogle Scholar
  • 6 Schaefer NR, Yaxley JP, O'Donohue P, Lisec C, Jeyarajan E. Electrical burn causing a unique pattern of neurological injury. Plast Reconstr Surg Glob Open 2015; 3 (04) e378
    CrossrefPubMedGoogle Scholar
  • 7 Fox IK, Novak CB, Krauss EM. et al. The use of nerve transfers to restore upper extremity function in cervical spinal cord injury. PM R 2018; 10 (11) 1173-1184.e2
    CrossrefPubMedGoogle Scholar
  • 8 Isaacs J, Allen D, Chen LE, Nunley II J. Reverse end-to-side neurotization. J Reconstr Microsurg 2005; 21 (01) 43-48 , discussion 49–50
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Farber SJ, Glaus SW, Moore AM, Hunter DA, Mackinnon SE, Johnson PJ. Supercharge nerve transfer to enhance motor recovery: a laboratory study. J Hand Surg Am 2013; 38 (03) 466-477
    CrossrefPubMedGoogle Scholar
  • 10 McInnes CW, Ha AY, Power HA, Tung TH, Moore AM. Femoral nerve decompression and sartorius-to-quadriceps nerve transfers for partial femoral nerve injury: a cadaveric study and early case series. J Neurosurg 2020; •••: 1-8
    CrossrefPubMedGoogle Scholar