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Page 4 of 16 Garbuzov et al. Plast Aesthet Res 2023;10:9 https://dx.doi.org/10.20517/2347-9264.2022.51

after excision of a gynecologic tumor
Tibial nerve repair
Koshima et al. (2003) [28] ● Case report ● Significant improvement in patient’s functional
● First description of nerve transfer for repair of tibial outcome. Both patients were able to walk at the last
nerve using the deep peroneal nerve follow up
Yin et al. (2015) [29] ● Case-series ● Significant symptom resolution was observed
● Evaluated the safety and efficacy of ipsilateral following the transfer
obturator-to-tibial nerve transfer in 5 consecutive ● Obturator-to-tibial nerve transfer is a feasible option
patients with sacral plexus injury when direct nerve repair is not plausible
[17]
Moore et al. (2017) ● Case-series and cadaveric study ● Efficient and safe transfer procedure for treatment of
● Investigated the distal femoral-to-sciatic nerve proximal tibial nerve injuries
transfer for proximal nerve injuries
Agarwal et al. (2018) [59] ● Prospective case-series ● At 6 months follow up, significant improvement in
● Saphenous nerve transfer to the posterior tibial nerve sensory perception was observed in most of sole
was carried out for 21 patients with loss of sensation at territories
the sole
[33]
Meng et al. (2018) ● Cadaveric study ● Femoral-to-sciatic nerve transfer is a feasible option
● Investigated the efficacy and safety of femoral nerve for restoring muscle and sensory function for sciatic
transfer to peroneal and tibial nerves for high sciatic nerve and its branches
nerve injury
Namazi et al. (2019) [60] ● Cadaveric study ● This technique is feasible for patients with sacral
● Evaluated the safety and feasibility of obturator to nerve root avulsion injury. However, no clinical
tibial nerve transfer with saphenous nerve graft outcomes are available
Peroneal nerve repair
Ferris et al. (2017) [31] ● Case-series ● Excellent functional outcomes were observed for 7/9
● Partial tibial nerve transfer was carried out for 9 patients. the study recommended nerve transfer as an
patients with traumatic peroneal nerve injury alternative therapeutic option
Nath et al. (2017) [32] ● Retrospective case-series ● The results of the study showed significant
● Investigated the surgical outcomes of 21 patients with improvement in functional outcome after the operation
foot drop undergoing nerve transfer
Meng et al. (2018) [33] ● Cadaveric study ● Femoral-to-sciatic nerve transfer is a feasible option
● Investigated the efficacy and safety of femoral nerve for restoring muscle and sensory function for sciatic
transfer to peroneal and tibial nerves for high sciatic nerve and its branches
nerve injury
[34]
Flores et al. (2013) ● Retrospective case-series ● Nerve transfer from the soleus muscle to the deep
● Investigated the efficacy and outcome of 13 patients peroneal nerve is not recommended due to unfavorable
with foot drop undergoing tibial-to-peroneal nerve patients outcomes
transfer

inspiration for future surgeons to utilize nerve transfer for femoral nerve injuries when a direct repair is not
possible due to a considerable nerve gap. Nevertheless, performing a transfer for an injured femoral nerve at
the pelvis can be challenging. Goubier and Tung assessed the anatomical feasibility of obturator-to-femoral
nerve transfer and confirmed that this nerve transfer is anatomically possible [19,20] . Since then, a few
modifications have been made to the femoral nerve transfer to maximize axonal regeneration and nerve
viability.

One of the most robust data on nerve transfer for femoral nerve repair came from the study by Peters
et al. . They previously reported success in treating high femoral nerve palsy using the motor branches of
[12]
the anterior obturator nerve to the gracilis, adductor longus, and adductor brevis muscles and the sartorius
motor branches to improve quadriceps function . Successful reinnervation to all four quadriceps muscles
[12]
[12]
has been reported in cases where the zone of injury was inaccessible, such as after hip surgery . In this
example, femoral nerve decompression was offered in conjunction with nerve transfer surgery as an adjunct
therapy for neuropathic pain .
[12]

In patients with multilevel lumbosacral plexus injuries with concomitant ipsilateral nerve damages,
restoration of knee extension has been reported using the contralateral obturator to the femoral nerve