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Table 1. Examples of the published articles on the use of nerve transfer for lower extremity nerve injuries
Study design
References Population characteristics Clinical outcome
Mean age ± SD, F; M ratio
Femoral nerve repair
Campbell et al. (2010) [18] ● Case report ● Excellent functional recovery and significant
● 45-year-old female with a retroperitoneal quadriceps functions at 2 years after the operation
schwannoma involving lumbar plexus
[20]
Goubier et al. (2012) ● Cadaveric study ● Confirmed that obturator-to-femoral nerve transfer is
● Investigated the anatomical feasibility of obturator- anatomically possible and may have clinical
to-femoral nerve transfer in 5 cadavers (10 thighs) implications
[19]
Tung et al. (2012) ● Cadaveric study ● Obturator-to-femoral nerve transfer is a safe and
● Evaluated the efficacy of obturator nerve transfer to efficient procedure for the treatment of high femoral
the femoral nerve in both human and cadaveric subjects nerve injuries
[53]
Karagiannis et al. (2015) ● Case report ● Significant functional recovery at 3 years post-
● 49-year-old man with right-sided femoral nerve palsy operation
undergoing dual gracilis and adductor longus to
quadriceps muscles
Inaba et al. (2018) [54] ●Case report ● Significant quadriceps recovery with 4/5 knee
● Partial obturator nerve transfer was done for the extension and normal gait
repair of an excised femoral nerve after resection of a
retroperitoneal schwannoma
[55]
Meng et al. (2018) ● Animal study (rat) ● A significant functional recovery and increase in
● Investigate the efficacy and feasibility of obturator quadriceps muscle mass in rat models after nerve
nerve transfer for repair of injured femoral nerve in rat transfer was observed
models
[56]
Rastrelli et al. (2018) ● Case report ● Obturator-to-femoral neve transfer is a feasible
● Anterior branch of the obturator nerve was option when the nerve gap is considerable (≥ 6 cm)
transferred to the femoral nerve at thigh level in a 19-
year-old female
Doi et al. (2019) [15] ● Case report ● At 14 months post-op, favorable functional outcome
● Contralateral obturator nerve transfer to the left with full knee extension was achieved
femoral nerve due to acute flaccid myelitis
Graham et al. (2020) [57] ● Case report ● At 4 years post-op, patient recovered knee extension
● A modified obturator-to-femoral neve transfer with (4/5) and mobilization was successful
cable grafting for a 49-year-old woman with iatrogenic
injury to the femoral nerve
[14]
Cao et al. (2020) ● Case report ● Contralateral obturator nerve transfer to femoral
● Contralateral obturator nerve transfer to femoral nerve is an alternative procedure when the ipsilateral
nerve after extensive lumbar plexus injury in a 30-year- obturator nerve is damaged
old male
[21]
Chen et al. (2020) ● Cadaveric study ● Suggested that the muscle branches of sciatic nerve
● Evaluate the safety and feasibility of sciatic nerve may be a reasonable candidate for femoral nerve repair
transfer to the femoral nerve in cadavers
[13]
Nicholas et al. (2021) ● Case report ● At the last follow-up, patients had 3/5 and 2/5 knee
● Reported two cases of extensive lumbosacral plexus extension, representing this nerve transfer as a
injury accompanied with root avulsion which underwent therapeutic option for extensive plexal injuries
contralateral obturator-to-femoral neve
Peters et el. (2021) [12] ● Retrospective case-series ● Post-operatively, a significant improvement in knee
● Reported the functional outcome of 14 patients with extension muscle power and pain compared with pre-
femoral nerve palsy that underwent femoral nerve operation (P-value = 0.001)
decompression and nerve transfer
[16]
Lubelski et al. (2021) ● Case-series ● Sciatic-to-femoral nerve transfer is a feasible option
● Demonstrated sciatic-to-femoral nerve transfer using for repair of extensive lumbar plexus damage.
a fascicle of the proximal tibial nerve as the donor for However, the clinical outcome of patients are not
pediatric patients with acute flaccid paralysis available
Donaldson et al. (2022) [58] ● Case-series ● At 6 months post-op, one patient regained significant
● Two patients with femoral nerve injuries underwent knee flexion and full knee extension with grade 4/5
concomitant gracilis muscle transfer and obturator-to- power.
femoral neve (adductor longus nerve branch) ● At 18 months post-op, patient 2 had full knee flexion
and extension with grade 5/5 muscle power
Obturator nerve repair
Spiliopoulos et al. ● Case report ● At 1 year post-op, patient gained full limb adduction
[27]
(2011) ● Femoral-to-obturator nerve transfer was done for a and full recovery was observed
female patient with a iatrogenic obturator nerve injury