Evaluation of the Sensory Deficit after Sural Nerve Harvesting in Pediatric Patients

Abstract

The sural nerve is a sensory nerve that innervates the proximal part of the lateral aspect of the foot. The sural nerve is often harvested for nerve grafting. Sensory loss in the area supplied by the sural nerve could be expected, causing a lack of protective sensation and a potential risk of injury. The sensory outcome of sural nerve harvesting has not been documented in children. The aim of this study was to evaluate the sensory deficit following sural nerve harvest in infants. The authors conducted a controlled study. Evaluation and mapping of the sensory thresholds in the sural nerve distribution were performed using the Semmes-Weinstein monofilament method on four predetermined sites on the foot. A questionnaire was used to elicit subjective findings. The inclusion criteria were children older than 6 years who had undergone bilateral sural nerve harvesting for brachial plexus reconstruction in the first year of life. Normal volunteers served as controls. Fourteen patients and 14 controls were enrolled in the study. Eighty-six percent of the feet that were operated on had a sensory deficit (p = 0.0001). The patients reported no concerns regarding the sensation of their feet. Sural nerve harvesting in children leaves a measurable sensory deficit; however, this deficit does not seem to have clinical implications for the patients.