Returning to life: how we restore nerves after injuries
We continue to provide assistance to our defenders. A unique operation was recently performed for gunshot damage to the peroneal nerve, the nerve responsible for foot movement. Our patient, a military man, has no dorsiflexion of the foot after a knee injury, which makes walking much more difficult. The injury was sustained two months ago.
Diagnostics and complexity of the task
After a detailed examination, we confirmed that it was damage to the peroneal nerve that caused the lack of foot movement. During the operation, we found that the nerve was torn and that there were scars at its ends called neuromas. These seals prevent the nerve fibers from growing back, so they had to be removed.
After the neuroma was removed, the distance between the nerve ends increased to 4 cm. Usually, if the distance is smaller, we can suture the nerve directly. However, in this case, due to a serious injury to the knee joint, the patient developed a contracture (inability to bend the leg), which made it impossible to connect the nerve ends.
Nerve prosthesis: the path to recovery
Since direct suturing was not possible, we decided to perform a nerve graft. We took small nerve fragments from another part of the patient's leg—the fibular nerve and the lateral cutaneous nerve of the leg. These fragments became "prostheses" that connected the severed ends of the peroneal nerve, providing a pathway for the nerve fibers to regrow.
The operation was successful, without complications. Now the patient faces the most important stage - recovery. The process of nerve regrowth is slow, about 1 mm per day, and takes a lot of time. However, the patient is very motivated and set on a positive outcome, which is a key factor for successful rehabilitation.
Operations team:
- Surgeon – Candidate of Medical Sciences Leontiev O. ,
- Assistant Zhuravlev O.,
- anesthesiologist Feshchenko B.-M.,
- operating room nurse Molchanova I.,
- anesthetist Uhryn H.
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