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; Li-Ching Lin; Johnny Chuieng-Yi Lu

doi:10.1055/s-0042-1756290

Archives of Plastic Surgery, Inhaltsverzeichnis

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

Autoren

Katie Pei-Hsuan Wu‡^*

¹Department of Physical Medicine and Rehabilitation, Chang Gung Medical University, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
Li-Ching Lin‡^*

²Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Medical University, Chang Gung Memorial Hospital, Linkou, Taiwan
Johnny Chuieng-Yi Lu

²Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Medical University, Chang Gung Memorial Hospital, Linkou, Taiwan

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

Volltext

Referenzen

References
1 Koumbourlis AC. Electrical injuries. Crit Care Med 2002; 30 (suppl 11): S424-S430
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
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
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
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
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
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
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
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
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