• Leandro Pretto Flores, Roberto Sérgio Martins, and Mario Gilberto Siqueira.
• †Unit of Neurosurgery, Hospital de Base do Distrito Federal, Brasília, Distrito Federal, Brazil; ‡Hospital Santa Helena, Brasília, Distrito Federal, Brazil; §Peripheral Nerve Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.
• Neurosurgery. 2013 Oct 1;73(4):609-15; discussion 615-6.

BackgroundFoot drop is a very debilitating condition affecting patients' daily activities, and its treatment has been a challenge for neurosurgeons. Grafting the peroneal or sciatic nerve usually results in poor outcomes. Our previous anatomic study demonstrated the feasibility of transferring a motor branch of the tibial nerve to the deep peroneal nerve at the level of the popliteal fossa.ObjectiveTo demonstrate the outcomes obtained after the transfer of a branch of the tibial nerve to the peroneal nerve for recovery of foot drop.MethodsA retrospective review of 13 patients with foot drop caused by injuries to a lumbar root or the sciatic or peroneal nerve, who underwent a transfer of the nerve of the soleus muscle to the deep peroneal nerve. The results were evaluated using the British Medical Research Council grading system.ResultsThree patients were lost to follow-up. Of the remaining 10 patients, the outcomes were considered good (Medical Research Council grade M3 or M4) in 2 patients (20%) concerning ankle dorsiflexion and in 2 patients concerning toe extension (20%). One patient reported a reduced calf circumference.ConclusionThe transfer of the nerve of the soleus muscle to the deep peroneal nerve demonstrated poor results in most of the patients, although favorable outcomes were observed in a few subjects. Due to the inconsistency of the results, we do not favor the routine use of this technique for the treatment of foot drop.

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