Direct muscle neurotization with long acellular nerve allograft: A case report

Sami H. Tuffaha, Jesse D. Meaike, Steven Lawrence Moran

Research output: Contribution to journalArticle

Abstract

Nerve repair and nerve transfer are the optimal approaches to restore function to denervated muscle. When the distal-most portion of the nerve entering the muscle is compromised, these are not possible and direct muscle neurotization (DMN) is considered. We describe the first reported case of DMN with acellular nerve allograft. The patient is a 25 year old male who sustained a blast injury to the patient's proximal leg with segmental injury to the deep peroneal nerve resulting in complete foot drop with 0/5 dorsiflexion and toe extension. Given complete obliteration of the distal nerve, we performed direct neurotization of the tibialis anterior muscle with a 7 cm acellular nerve allograft coapted to the proximal stump of the deep peroneal nerve. At 3 years after surgery, the patient regained 5/5 strength with dorsiflexion and toe extension and normal gait. This case supports the use of acellular nerve allografts to restore function to denervated muscle when the distal nerve stump is not available for nerve repair or transfer and there is a desire to avoid the morbidity of autologous nerve graft harvest.

Original languageEnglish (US)
JournalMicrosurgery
DOIs
StateAccepted/In press - Jan 1 2019

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Nerve Transfer
Allografts
Muscles
Peroneal Nerve
Toes
Blast Injuries
Gait
Foot
Leg
Morbidity
Transplants
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Direct muscle neurotization with long acellular nerve allograft : A case report. / Tuffaha, Sami H.; Meaike, Jesse D.; Moran, Steven Lawrence.

In: Microsurgery, 01.01.2019.

Research output: Contribution to journalArticle

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