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  4. Application of Supercharge End-to-Side (SETS) Obturator to Femoral Nerve Transfer in Electrical Injury-Induced Neuropathy to Improve Knee Extension

Application of Supercharge End-to-Side (SETS) Obturator to Femoral Nerve Transfer in Electrical Injury-Induced Neuropathy to Improve Knee Extension

Arch Plast Surg, 2022 · DOI: https://doi.org/10.1055/s-0042-1756290 · Published: December 13, 2022

NeurologySurgeryTrauma

Simple Explanation

Electrical injuries can cause nerve damage, leading to muscle weakness and difficulty moving. This paper describes a case where a patient suffered femoral nerve damage, impacting their ability to extend their knee. The patient also had spinal cord injury which resulted in spasticity of the posterior thigh muscles, further limiting knee extension. Traditional nerve repair techniques were not suitable because the exact site of nerve disruption was not identifiable. The surgeons used a novel approach called Supercharge End-to-Side (SETS) nerve transfer, taking a nerve from the inner thigh (obturator nerve) and connecting it to the femoral nerve to improve knee extension. They also performed fractional tendon lengthening to release the spastic muscles.

Study Duration
1 year
Participants
1 male patient
Evidence Level
Case report

Key Findings

  • 1
    The SETS nerve transfer technique, combined with tendon lengthening, significantly improved knee extension in a patient with electrical injury-induced femoral neuropathy and spinal cord injury.
  • 2
    One year after surgery, the patient showed improved knee extension strength and range of motion, as well as improved gait efficiency and stability.
  • 3
    The patient reported greater improvement in the left limb compared to the right limb following the SETS procedure.

Research Summary

This case report describes the successful application of SETS obturator to femoral nerve transfer in a patient with electrical injury-induced femoral neuropathy and spinal cord injury. The SETS technique, combined with fractional tendon lengthening, resulted in significant improvement in knee extension strength and range of motion, as well as improved gait efficiency and stability. The authors suggest that this strategy can be applied in larger series of patients with similar presentations to enhance patient’s quality of life.

Practical Implications

Novel Treatment Strategy

The SETS nerve transfer technique provides a promising alternative for patients with partial femoral nerve injuries, especially when traditional nerve repair methods are not feasible.

Improved Patient Outcomes

Combining SETS with tendon lengthening can significantly improve knee extension, gait, and overall quality of life for patients with combined femoral nerve and spinal cord injuries.

Wider Application

This case suggests that SETS nerve transfer may be a valuable treatment option for a broader range of patients with similar nerve injuries.

Study Limitations

  • 1
    Single case report
  • 2
    Limited follow-up period
  • 3
    Subjective patient reported outcomes

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