Peroneal Nerve Dysfunction in Epiphyseal Transfer

NCT ID: NCT05884827

Last Updated: 2024-02-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

15 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-06-01

Study Completion Date

2024-09-30

Brief Summary

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Assessment of peroneal nerve dysfunction after proximal fibular epiphyseal resection and evaluation of clinical outcome and EMG changes.

Detailed Description

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In children the preserved epiphysis of the proximal fibula ensure the exceptional ability to recover both joint function and longitudinal limb growth at the same time. Traumatic bone defect, congenital malformations, malignant bone lesions and infection are all current indications for VFET. The shape and size of the proximal fibular epiphysis aid in the gradual remodeling of the articular surface, allowing for better reconstruction and eventual rehabilitation over time.

Harvesting the proximal epiphysis of the fibula, along with its intact blood supply, is technically demanding, and the success of VFET is a primarily dependent on restoring adequate vascularity to the growth plate and diaphysis.

Anterior tibial artery is the primary and most consistent contributor to the proximal fibular epiphysis and proximal two thirds of diaphysis, it has intimate connection to the motor (deep) branch of peroneal nerve. The success of anterior tibial artery based VFET based on preserving the anterior tibial Vascular bundle, so it may be necessary to sacrifice some branches of peroneal nerve to tibialis anterior muscle. This is a significant flaw in the approach that could result in permanent peroneal nerve palsy.

Conditions

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Epiphyseal Arrest

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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EMG

Measure the electrical activity of the muscle and nerve

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* all patients candidate for epiphyseal transfer are included ( patients with traumatic bone defect, congenital malformations, malignant bone lesions and infection )

Exclusion Criteria

* patients in which there's no injury of nerve supply of tibialis anterior has occurred intraoperative
Minimum Eligible Age

18 Months

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Moustafa Elsese

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Omar

Asyut, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Ahmed Moustafa Elsese, Resident

Role: CONTACT

01009246781

Omar Ahmed Refai, Consultant

Role: CONTACT

01003412298

Facility Contacts

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Omar Ahmed Refai, Consultant

Role: primary

01003412298

References

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Shammas RL, Avashia YJ, Farjat AE, Catanzano AA, Levin LS, Eward WC, Brigman BE, Erdmann D. Vascularized Fibula-Based Physis Transfer: A Follow-Up Study of Longitudinal Bone Growth and Complications. Plast Reconstr Surg Glob Open. 2017 May 25;5(5):e1352. doi: 10.1097/GOX.0000000000001352. eCollection 2017 May.

Reference Type BACKGROUND
PMID: 28607872 (View on PubMed)

Ghert M, Colterjohn N, Manfrini M. The use of free vascularized fibular grafts in skeletal reconstruction for bone tumors in children. J Am Acad Orthop Surg. 2007 Oct;15(10):577-87. doi: 10.5435/00124635-200710000-00001.

Reference Type BACKGROUND
PMID: 17916780 (View on PubMed)

Innocenti M, Delcroix L, Romano GF. Epiphyseal transplant: harvesting technique of the proximal fibula based on the anterior tibial artery. Microsurgery. 2005;25(4):284-92. doi: 10.1002/micr.20130.

Reference Type BACKGROUND
PMID: 15934045 (View on PubMed)

Sales de Gauzy J, Accadbled F, Gomez Brouchet A, Abid A. Case report: histologic study of a human epiphyseal transplant at 3 years after implantation. Clin Orthop Relat Res. 2009 Jul;467(7):1915-20. doi: 10.1007/s11999-009-0723-z. Epub 2009 Feb 11.

Reference Type BACKGROUND
PMID: 19212796 (View on PubMed)

Grimer RJ. Surgical options for children with osteosarcoma. Lancet Oncol. 2005 Feb;6(2):85-92. doi: 10.1016/S1470-2045(05)01734-1.

Reference Type BACKGROUND
PMID: 15683817 (View on PubMed)

Zelenski N, Brigman BE, Levin LS, Erdmann D, Eward WC. The vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects. Sarcoma. 2013;2013:321201. doi: 10.1155/2013/321201. Epub 2013 Oct 7.

Reference Type BACKGROUND
PMID: 24222724 (View on PubMed)

Other Identifiers

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EMG in Epiphyseal transfer

Identifier Type: -

Identifier Source: org_study_id

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