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Cirugía Plástica Ibero-Latinoamericana

On-line version ISSN 1989-2055Print version ISSN 0376-7892

Abstract

ROJAS, Leonardo; LACOUTURE, Carlos; INIGO, Federico  and  CARDENAS, Alexander. Multicentric experience in lower limb nerve reconstruction. Cir. plást. iberolatinoam. [online]. 2019, vol.45, n.4, pp.413-426.  Epub Mar 02, 2020. ISSN 1989-2055.  https://dx.doi.org/10.4321/s0376-78922019000400011.

Background and objective

The nerve injuries in the lower limb are a major problem because they cause functional limitation in the affected extremity; these limitations can be sensitive, motor or both. The nerve reconstruction of lower limb is a challenging procedure because it requires huge knowledge of the pathology and surgeon expertise.

We present our experience in lower limb nerve reconstruction in the Universitary Hospital Clínica San Rafael in Bogotá (Colombia) and Hospital Manuel Gea González in México D.F. (México). In addition, sensory neurotization of the internal saphenous nerve to the posterior tibial nerve is presented for the first time.

Methods

Information was collected from 9 patients with nerve injuries of the lower limbs, the most representative according to location and etiology, who attended the specialized clinic of peripheral nerve, 3 at the Manuel Gea González Hospital and 6 at the Universitary Hospital Clínica San Rafael, and that required microsurgical nerve reconstruction.

Results

In all cases, functional and/or sensory recovery of the affected limb was obtained. The sensory neurotization of the internal saphenous nerve to the tibial is described for the first time, to recover the sensation of the sole of the foot.

Conclusions

The closer the lesion is, the longer it takes to recover. Sensory neurotization of the internal saphenous nerve to the tibial nerve is an effective procedure. The use of different surgical techniques favors adequate nerve reconstruction. Lesions with evolution less than 1 year and nerve gaps smaller than 6 cm are factors of good prognosis for the recovery of patients.

Keywords : Lower limb; Nerve reconstruction; Sural nerve; Microsurgery; Tendon transfer.

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