{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:09:26Z","timestamp":1791382166035,"version":"4.3.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":142,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Brachial Plex Peripher Nerve Inj"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Multiple nerve transfer techniques are used to treat patients with nerve injuries when a primary repair is not possible. These techniques are categorized to end-to-end, end-to-side, and side-to-side neurorrhaphy. Our study aims to explore the utility of the cross-bridge ladder technique (H-shaped), which has shown promising results in animal models and probably underutilized clinically.<\/jats:p><jats:p>\n          Methods\u2003Four patients with significant loss of ankle dorsiflexion were seen in the clinic and underwent evaluation, including electrodiagnostic studies. A cross-bridge ladder repair technique was used between the tibial nerve as the donor and the common peroneal nerve as the recipient via one or two nerve grafts coapted in parallel with end-to-side neurorrhaphies. Dorsiflexion strength was measured preoperatively using the Medical Research Council (MRC) grading system and at each postoperative follow-up appointment.<\/jats:p><jats:p>\n          Results\u2003All four patients had suffered persistent and severe foot drop (MRC of 0) following trauma that had occurred between 6 and 15 months preoperatively. Three of the four patients improved to an MRC of 2 several months postoperatively. The last patient had an immediate improvement to an MRC of 2 by his first month and had a complete recovery of ankle dorsiflexion within 4 months from surgery.<\/jats:p><jats:p>\n          Conclusion\u2003We demonstrate the utility and clinical outcomes of the cross-bridge ladder technique in patients with persistent and prolonged foot drop following trauma. Both early and late recovery were seen while all patients regained motor function, with some patients continuing to improve up to the most recent follow-up.<\/jats:p><jats:p>IRB Approval: Obtained 2013\u20131411-CP005<\/jats:p>","DOI":"10.1055\/s-0043-1768996","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T23:14:18Z","timestamp":1684883658000},"page":"e21-e26","source":"Crossref","is-referenced-by-count":2,"title":["Peroneal Nerve Repair with Cross-Bridge Ladder Technique: Parallel End-to-Side Neurorrhaphies"],"prefix":"10.1055","volume":"18","author":[{"given":"Simon","family":"Ammanuel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Burkett","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evalina S.","family":"Bond","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amgad S.","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/(SICI)1098-1136(199708)20:4<333::AID-GLIA6>3.0.CO;2-6","article-title":"Effects of delayed re-innervation on the expression of c-erbB receptors by chronically denervated rat Schwann cells in vivo","volume":"20","author":"H Li","year":"1997","journal-title":"Glia"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1002\/(SICI)1098-1136(199811)24:3<290::AID-GLIA3>3.0.CO;2-6","article-title":"Chronically denervated rat Schwann cells respond to GGF in vitro","volume":"24","author":"H Li","year":"1998","journal-title":"Glia"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"3876","DOI":"10.1523\/JNEUROSCI.15-05-03876.1995","article-title":"Contributing factors to poor functional recovery after delayed nerve repair: prolonged axotomy","volume":"15","author":"S Y Fu","year":"1995","journal-title":"J Neurosci"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"3886","DOI":"10.1523\/JNEUROSCI.15-05-03886.1995","article-title":"Contributing factors to poor functional recovery after delayed nerve repair: prolonged denervation","volume":"15","author":"S Y Fu","year":"1995","journal-title":"J Neurosci"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1529-8027.2000.00026.x","article-title":"Influence of aging on peripheral nerve function and regeneration","volume":"5","author":"E Verd\u00fa","year":"2000","journal-title":"J Peripher Nerv Syst"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/cne.903420105","article-title":"Ventral root avulsion: an experimental model of death of adult motor neurons","volume":"342","author":"V E Koliatsos","year":"1994","journal-title":"J Comp Neurol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"e0127397","DOI":"10.1371\/journal.pone.0127397","article-title":"Nerve cross-bridging to enhance nerve regeneration in a rat model of delayed nerve repair","volume":"10","author":"T Gordon","year":"2015","journal-title":"PLoS One"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1227\/NEU.0b013e31821246a8","article-title":"Side-to-side nerve grafts sustain chronically denervated peripheral nerve pathways during axon regeneration and result in improved functional reinnervation","volume":"68","author":"A Ladak","year":"2011","journal-title":"Neurosurgery"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/BF00309336","article-title":"Axonal regeneration into chronically denervated distal stump. 1. 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