ORIGINAL ARTICLE - PERIPHERAL NERVES
Transfer of obturator nerve for femoral nerve injury:
an experiment study in rats
Received: 1 April 2018 /Accepted: 10 May 2018
Springer-Verlag GmbH Austria, part of Springer Nature 2018
Background Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previ-
ously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied.
In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the
randomized control method.
Methods Sixty Sprague–Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral
neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral
neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment.
Results At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of
the knee and higher BBB score, as compared to the control group (p < 0.05). The muscle mass and myofiber cross-sectional area
of the quadriceps were heavier and larger than those in the control group (p < 0.05). A regenerated nerve with myelinated and
unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks
postoperatively (p >0.05).
Conclusions Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence
be considered as an option for the treatment of femoral nerve injury.
Keywords Nerve transfer
Femoral nerve injury
Iatrogenic injury and malignant processes are the leading
causes of quadriceps palsy, which involves the proximal inju-
ry of the femoral nerve [1, 2]. This condition affects lower
limb function and reduces walking ability. Nerve grafting
and nerve transfer are two major options for the treatment of
peripheral nerve injury [3–7]. Due to its adjacent anatomic
location and suitable nerve diameter [5, 8], the obturator nerve
is recommended as a donor motor nerve for transfer to the
femoral nerve; this technique could reduce the reinnervation
distance and gain a faster regeneration time than grafting [9,
10]. Certain clinical case reports have described this treatment
method, although the number remains insufficient and the
outcomes have varied [10–13]. In the present study, we aimed
to confirm the feasibility and effectiveness of obturator nerve
transferring for repairing femoral nerve injury in a rodent
model using the randomized control method, along with his-
tological and morphometric methods.
Materials and methods
A total of 60 Sprague–Dawley rats, each weighing 220–280 g,
were randomly divided into two groups: the experiment group
Depeng Meng and Jun Zhou contributed equally to this work.
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s00701-018-3565-1) contains supplementary
material, which is available to authorized users.
* Haodong Lin
Department of Orthopedics, Changzheng Hospital, Second Military
Medical University, Shanghai 200003, People’sRepublicofChina
Department of Orthopedics, the Second People’s Hospital of
Karamay, Karamay, Xinjiang Province, People’s Republic of China