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J Reconstr Microsurg 1993; 9(2): 77-80
DOI: 10.1055/s-2007-1006655
ORIGINAL ARTICLE

© 1993 by Thieme Medical Publishers, Inc.

Direct Muscle Neurotization Recovers Gastrocnemius Muscle Function

Susan E. Mackinnon, J. Arline McLean, Gordon A. Hunter
  • From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, Division of Neurology and Department of Orthopedic Surgery, University of Toronto
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Publication History

Accepted for publication 1992

Publication Date:
08 March 2008 (online)

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ABSTRACT

This case report describes a devastating injury in which a distal motor nerve had been avulsed from the muscle belly and was not available for reconstruction. This otherwise irreparable posterior tibial nerve injury was successfully treated by direct neurotization of the muscle belly. The patient did have one small, intact, muscular branch to the medial gastrocnemius muscle; however, electrodiagnostic and clinical examination and recovery pattern suggested the neurotization procedure was responsible for the functional recovery. In the rare situation where no distal nerve is available, and tendon transfers or arthrodesis are inappropriate, direct muscle neurotization can be considered as a salvage technique.

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