Repair of the femoral nerve by two motor branches of the obturator nerve: A case report

Complete femoral nerve palsies are uncommon but devastating injuries when they are caused by large nerve defects. Direct repair is usually not possible and nerve grafting renders uncertain outcomes. Recent studies proposed different peripheral nerve transfers as treatment strategies for large femoral nerve defects. We report a clinical application of a nerve transfer to reinnervate the quadriceps muscle with two motor branches of the obturator nerve in a 48 years-old man that was diagnosed with a femoral nerve palsy after resection of a retroperitoneal schwannoma. The branches supplying the gracilis and adductor longus muscles were transferred to the motor branch of the femoral nerve to the quadriceps muscle at 6 months postinjury. At 34 months of follow-up, knee extension was quoted M4. The presented nerve transfer may be feasible, technically simple, and renders good functional outcomes.