Obturator Nerve Transfer as an Option for Femoral Nerve Repair: Case Report
Obturator Nerve Transfer as an Option for Femoral Nerve Repair: Case Report
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DOI：
10.1227/01.neu.0000369649.31232.b0
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发表时间：
2010-06
影响因子：
2.3
通讯作者：
Ashley A. Campbell;F. Eckhauser;A. Belzberg;J. Campbell
中科院分区：
文献类型：
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作者：
Ashley A. Campbell;F. Eckhauser;A. Belzberg;J. Campbell
目的神经移植已被证明是臂丛神经损伤修复中重要的辅助手段，但在下肢神经修复中很少使用。在这里，我们提出什么被认为是第一次描述成功转移闭孔神经到股神经。临床表现：一名45岁的女性，在切除腹膜后一个大的（15厘米）神经鞘瘤累及腰丛后，出现了一个完整的股神经病变。术后3个月将闭孔神经转移至腹股沟韧带腹膜后间隙股神经远端残端。在修复后2年，患者表现出4 / 5的四头肌功能恢复（医学研究委员会分级），并且能够几乎正常行走。结论对于股神经存在广泛缺损的病例，采用闭孔神经移植修复是传统神经移植修复的一种选择。
OBJECTIVE Nerve transfers have proved to be an important addition to the armamentarium in the repair of brachial plexus lesions, but have been used sparingly for lower extremity nerve repair. Here, we present what is believed to be the first description of a successful transfer of the obturator nerve to the femoral nerve. CLINICAL PRESENTATION A 45-year-old woman presented with a complete femoral nerve lesion after removal of a large (15-cm) schwannoma of the retroperitoneum involving the lumbar plexus. INTERVENTION The obturator nerve was transferred to the distal stump of the femoral nerve in the retroperitoneal space at the inguinal ligament three months post-injury. At 2 years post-repair, the patient demonstrated 4 out of 5 return (Medical Research Council grade) of quadriceps function and was able to walk nearly normally. CONCLUSION In cases in which there are extensive gaps in the femoral nerve, transfer of the obturator nerve provides an option to traditional nerve graft repair.