Lower extremity nerve transfers: an under-appreciated reconstructive approach

Lower extremity peripheral nerve injuries can be highly morbid to patients and challenging problems for reconstructive surgeons manage. Nerve transfers have recently emerged as a promising technique in the treatment of these injuries. The nerve-transfer paradigm is predicated on use an expendable, unaffected donor axons restore motor or sensory function target end organ. Distal close organ may allow earlier more robust reinnervation compared proximal primary repair grafting. However, clinical data outcomes rigorous comparative studies remain scarce, must rely principle-based including detailed understanding lower neuromuscular anatomy, gait mechanics, physiology develop appropriate plan each patient with goal functional limb restoration independent gait. In this article, we review current concepts transfers, techniques according indication.