Targeted Muscle Reinnervation in the Lower Leg: An Anatomical Study

Plastic and Reconstructive Surgery
Megan E FracolGregory A Dumanian

Abstract

Targeted muscle reinnervation reroutes the ends of cut nerves to reinnervate small motor nerves of nearby muscles, with the goal of reducing neuroma pain and/or improving prosthesis function. Anatomical roadmaps for targeted muscle reinnervation have been established in the upper extremity and thigh, but not for the lower leg. The major branch points of motor nerves and the motor entry points to muscles of the leg were dissected in five cadaver specimens. Leg length was defined as distance from the lateral femoral condyle to the lateral malleolus. The distances from the lateral femoral condyle to major branch points and motor entry points were recorded as percentages of leg length to identify targets for targeted muscle reinnervation. The tibialis anterior and extensor digitorum longus were both acceptable targets in the anterior compartment, with an average 4.4 motor entry points within 10 to 80 percent and 3.0 motor entry points within 20 to 80 percent leg length, respectively. The peroneus longus was the best target in the lateral compartment, with an average 5.8 motor entry points within 20 to 70 percent leg length. The gastrocnemius and soleus were both acceptable targets in the superficial posterior compartment, with an a...Continue Reading

References

Nov 15, 2006·Plastic and Reconstructive Surgery·John B HijjawiGregory A Dumanian
Sep 5, 2009·Plastic and Reconstructive Surgery·Gregory A DumanianTodd A Kuiken
Dec 22, 2011·Plastic and Reconstructive Surgery·Sonya P AgnewTodd A Kuiken
Feb 25, 2014·Clinical Orthopaedics and Related Research·Jason M SouzaGregory A Dumanian
Sep 1, 2015·The Journal of Hand Surgery·Michael S GartGregory A Dumanian
Jun 25, 2016·Foot & Ankle International·Jason M SouzaGregory A Dumanian

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Citations

Oct 4, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·You-Jin ChoiHun-Mu Yang
Feb 26, 2020·Plastic and Reconstructive Surgery. Global Open·Megan E FracolJason H Ko
Feb 26, 2020·Plastic and Reconstructive Surgery. Global Open·Lindsay E JanesGregory A Dumanian
Jun 13, 2019·JBJS Reviews·Christine Oh, Brian T Carlsen
Jan 7, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Christine C JohnsonR Glenn Gaston
Nov 19, 2020·EFORT Open Reviews·Gerhard M HobuschReinhard Windhager
Nov 3, 2020·Plastic and Reconstructive Surgery·Steven T LanierGregory A Dumanian
Jan 12, 2019·Journal of the American College of Surgeons·Ian L ValerioBenjamin K Potter
Aug 18, 2020·Plastic and Reconstructive Surgery. Global Open·Timothy H F DaughertyReuben A Bueno
Jun 28, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·David D KrijghJ Henk Coert
Jun 14, 2021·The Journal of Hand Surgery·Timothy P Fowler
Jul 14, 2021·Hand Clinics·Lindsay E JanesJason H Ko
Aug 10, 2021·Frontiers in Neurorobotics·Alison M KarczewskiSamuel O Poore

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