Contralateral Obturator Nerve to Femoral Nerve Transfer for Restoration of Knee Extension After Acute Flaccid Myelitis: A Case Report.

CASE A 7-year-old boy presented with left femoral and obturator nerves (ONs) palsy after an asthmatic attack with a viral prodrome, and his right lower limb was unaffected. He was diagnosed with acute flaccid myelitis (AFM) after positive spinal magnetic resonance imaging findings. After contralateral ON to femoral nerve transfer (CONFNT), his left quadriceps was reinnervated at 5.5 months, full knee extension was recovered at 14 months, and good functional outcomes were achieved at 31 months. CONCLUSIONS This first clinical report on CONFNT demonstrated a feasible good alternative in treating young patients with AFM with unilateral L2-L4 palsy and short duration of deficit.

[1]  Y. Nishiura,et al.  For how long do denervated muscles in children retain the ability to regenerate?: Restoration of elbow flexion and shoulder function by partial nerve transfer in a child with long-standing poliomyelitis-like paralysis. , 2019, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[2]  S. Wolfe,et al.  Nerve Transfers for Enterovirus D68-Associated Acute Flaccid Myelitis: A Case Series. , 2018, Pediatric neurology.

[3]  T. Shiihara,et al.  Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August–December 2015 , 2017, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  S. Hopkins Acute Flaccid Myelitis: Etiologic Challenges, Diagnostic and Management Considerations , 2017, Current Treatment Options in Neurology.

[5]  A. Roche,et al.  Tensor fasciae latae-tendon transfer for functional reconstruction of the quadriceps muscle after femoral nerve palsy. , 2015, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[6]  C. Hou,et al.  Anatomical feasibility of transferring the obturator and genitofemoral nerves to repair lumbosacral plexus nerve root avulsion injuries , 2014, Clinical anatomy.

[7]  K. Doi,et al.  Restoration of prehensile function for motor paralysis in Hopkins syndrome: case report. , 2014, The Journal of hand surgery.

[8]  T. Takagi,et al.  Outcome of surgical reconstruction after traumatic total brachial plexus palsy. , 2013, The Journal of bone and joint surgery. American volume.

[9]  A. Moore,et al.  Obturator Nerve Transfer for Femoral Nerve Reconstruction: Anatomic Study and Clinical Application , 2012, Plastic and reconstructive surgery.

[10]  J. Goubier,et al.  Transfer of two motor branches of the anterior obturator nerve to the motor portion of the femoral nerve: An anatomical feasibility study , 2012, Microsurgery.

[11]  J. Terzis,et al.  Free Muscle Transfer in Posttraumatic Plexopathies: Part 1: The Shoulder , 2010, Annals of plastic surgery.

[12]  Christiaan H. Schrag,et al.  Surgical Strategies for Brachial Plexus Polio-Like Paralysis , 2007, Plastic and reconstructive surgery.

[13]  T. Omura,et al.  Restoration of shoulder function and elbow flexion by nerve transfer for poliomyelitis-like paralysis caused by enterovirus 71 infection. , 2007, The Journal of bone and joint surgery. British volume.

[14]  E. Riska Transposition of the tractus ilio-tibialis to the patella as a treatment of quadriceps paralysis and certain deformities of the lower extremity after poliomyelitis. , 1962, Acta orthopaedica Scandinavica.

[15]  C. C. Yount AN OPERATION TO IMPROVE FUNCTION IN QUADRICEPS PARALYSIS , 1938 .

[16]  F. R. Ober Tendon Transplantation in the Lower Extremity , 1933 .