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the leg muscles was preserved in this case, the insensate
foot can be equally disabling due to loss of position
sense and predisposition to injuries to the plantar foot.
Atrophy and vasomotor changes complicate the injury.
Furthermore, the paralysis of the intrinsic muscles of the
foot leads to deformities over a period.
These patients need to protect their feet from injuries
till they regain the protective sensations. Importance of
the care of the insensate part has to be stressed during
each follow‑up visit. At the initial visit, the exploration
of the wound for debridement and assessment of injury
and the middle third of the leg for assessing the status
of the proximal stump were necessary. We feel that these
could have been possible through two separate incisions
to decrease scarring. The nerve reconstruction also would
Figure 5: Picture from the progress note: showing an easy way of have been possible at a later date through the same scars
monitoring the recovery
by tunneling the nerve grafts subcutaneously. In this case
as the initial scar was present we went through the same
can be considered analogues to brachial plexus injuries scar for reconstruction.
where the forces involved usually avulse the nerves from
a relatively fixed point. This may also help in explaining In a selected and cooperative patient, nerve grafting in
the fact that the upper roots are either avulsed or lower extremity can result in rewarding results.
ruptured (as they have few branches in the neck), but the
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one and half years after the reconstruction, and her age Isolated tibial nerve injury: a rare presentation. Plast Aesthet Res
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Injury to the tibial nerve in the lower leg leads to the loss Source of Support: Nil, Conflict of Interest: None declared.
of sensation at the plantar foot. Though the function of Received: 29-08-2014; Accepted: 13-10-2014

Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015 87