Obturator Nerve Transfer as an Option for Femoral Nerve Repair

OBJECTIVE: Nerve transfers have proved to be an important addition to the armamentarium in the repair of brachial plexus lesions, but have been used sparingly for lower extremity nerve repair. Here, we present what is believed to be the first description of a successful transfer of the obturator nerve to the femoral nerve. CLINICAL PRESENTATION: A 45-year-old woman presented with a complete femoral nerve lesion after removal of a large (15-cm) schwannoma of the retroperitoneum involving the lumbar plexus. INTERVENTION: The obturator nerve was transferred to the distal stump of the femoral nerve in the retroperitoneal space at the inguinal ligament three months post-injury. At 2 years post-repair, the patient demonstrated 4 out of 5 return (Medical Research Council grade) of quadriceps function and was able to walk nearly normally. CONCLUSION: In cases in which there are extensive gaps in the femoral nerve, transfer of the obturator nerve provides an option to traditional nerve graft repair.