{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:13:29Z","timestamp":1788383609795,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>The peroneal nerve is one of the most commonly injured nerves of the lower extremity. Nerve grafting has been shown to result in poor functional outcomes. The aim of this study was to evaluate and compare anatomical feasibility as well as axon count of the tibial nerve motor branches and the tibialis anterior motor branch for a direct nerve transfer to reconstruct ankle dorsiflexion. In an anatomical study on 26 human body donors (52 extremities) the muscular branches to the lateral (GCL) and the medial head (GCM) of the gastrocnemius muscle, the soleus muscle (S) as well as the tibialis anterior muscle (TA) were dissected, and each nerve\u2019s external diameter was measured. Nerve transfers from each of the three donor nerves (GCL, GCM, S) to the recipient nerve (TA) were performed and the distance between the achievable coaptation site and anatomic landmarks was measured. Additionally, nerve samples were taken from eight extremities, and antibody as well immunofluorescence staining were performed, primarily evaluating axon count. The average diameter of the nerve branches to the GCL was 1.49 \u00b1 0.37, to GCM 1.5 \u00b1 0.32, to S 1.94 \u00b1 0.37 and to TA 1.97 \u00b1 0.32 mm, respectively. The distance from the coaptation site to the TA muscle was 43.75 \u00b1 12.1 using the branch to the GCL, 48.31 \u00b1 11.32 for GCM, and 19.12 \u00b1 11.68 mm for S, respectively. The axon count for TA was 1597.14 \u00b1 325.94, while the donor nerves showed 297.5 \u00b1 106.82 (GCL), 418.5 \u00b1 62.44 (GCM), and 1101.86 \u00b1 135.92 (S). Diameter and axon count were significantly higher for S compared to GCL as well as GCM, while regeneration distance was significantly lower. The soleus muscle branch exhibited the most appropriate axon count and nerve diameter in our study, while also reaching closest to the tibialis anterior muscle. These results indicate the soleus nerve transfer to be the favorable option for the reconstruction of ankle dorsiflexion, in comparison to the gastrocnemius muscle branches. This surgical approach can be used to achieve a biomechanically appropriate reconstruction, in contrast to tendon transfers which generally only achieve weak active dorsiflexion.<\/jats:p>","DOI":"10.3390\/jpm13020344","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T04:51:46Z","timestamp":1676523106000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Distal Nerve Transfers in High Peroneal Nerve Lesions: An Anatomical Feasibility Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Stefan","family":"Salminger","sequence":"first","affiliation":[{"name":"AUVA Trauma Hospital Lorenz B\u00f6hler\u2014European Hand Trauma Center, Donaueschingenstrasse 13, 1200 Vienna, Austria"},{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0092-568X","authenticated-orcid":false,"given":"Clemens","family":"Gstoettner","sequence":"additional","affiliation":[{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic and Reconstructive Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5194-9118","authenticated-orcid":false,"given":"Lena","family":"Hirtler","sequence":"additional","affiliation":[{"name":"Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Blumer","sequence":"additional","affiliation":[{"name":"Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Fuchssteiner","sequence":"additional","affiliation":[{"name":"Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1011-3482","authenticated-orcid":false,"given":"Gregor","family":"Laengle","sequence":"additional","affiliation":[{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic and Reconstructive Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0694-8252","authenticated-orcid":false,"given":"Johannes A.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic, Aesthetic and Reconstructive Surgery, Karl Landsteiner University of Health Sciences, University Hospital St. Poelten, 3100 Krems, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3910-9727","authenticated-orcid":false,"given":"Konstantin D.","family":"Bergmeister","sequence":"additional","affiliation":[{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic and Reconstructive Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic, Aesthetic and Reconstructive Surgery, Karl Landsteiner University of Health Sciences, University Hospital St. Poelten, 3100 Krems, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-0073","authenticated-orcid":false,"given":"Wolfgang J.","family":"Weninger","sequence":"additional","affiliation":[{"name":"Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar C.","family":"Aszmann","sequence":"additional","affiliation":[{"name":"Deparment of Plastic and Reconstructive Surgery, Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Plastic and Reconstructive Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"ref_1","first-page":"625","article-title":"Immediate and secondary reconstruction of iatrogenic nerve lesions","volume":"78","author":"Salminger","year":"2014","journal-title":"Chir. 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