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Fascicular Nerve Transfer For Treatment Of Foot Drop: Long-term Outcomes
Alexander G. Chartrain, MD, Mitchel Seruya, MD.
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Purpose: This study evaluated the long-term outcomes for a distal fascicular nerve transfer technique developed to reinnervate and balance the ankle for patients with foot drop.
Methods: This retrospective review of a prospectively collected database included adult patients presenting from 12/1/2020 to 9/30/2024 with profound foot drop. Patients with less than 12 months of post-operative follow up, those given an updated diagnosis of lower motor neuron (LMN) disease, and those who sustained tendon rupture were excluded.
Results: Twenty-five patients, 26 individual limbs, were included. Foot drop etiology included lumbar spine (N=9, 34.6%), sciatic nerve (N=8, 30.8%), and common peroneal nerve (N=9, 34.6%). The average time from injury onset to surgery was 8.1 months (IQR 5.1-11.3) and the average post-operative follow up was 27.4 months (IQR 19.0-37.0). Dorsiflexion strength improvement at last follow up was statistically significant (average pre-op MRC grade = 0.6, SD 1.2; average post-op MRC grade = 3.9, SD 1.1; p<0.001), as was eversion strength (average pre-op MRC grade = 0.7, SD 1.3; average post-op MRC grade = 4.4, SD 0.7; p<0.001). Twenty patients (76.9%) were AFO-independent at the time of last follow-up. On average, AFO-independence was achieved at 15.2 months (IQR 8.0-21.5); see Figure 1.
Conclusions: This long-term study of distal fascicular nerve transfer for foot drop shows a high rate (76.9%) of patients achieved AFO-independent ambulation.
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