Acta Neurochirurgica

, Volume 160, Issue 7, pp 1385–1391 | Cite as

Transfer of obturator nerve for femoral nerve injury: an experiment study in rats

  • Depeng Meng
  • Jun Zhou
  • Yaofa Lin
  • Zheng Xie
  • Huihao Chen
  • Ronghua Yu
  • Haodong LinEmail author
  • Chunlin Hou
Original Article - Peripheral Nerves



Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously 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.


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.


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).


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.


Nerve transfer Quadriceps palsy Obturator nerve Femoral nerve injury Rodent model 


Funding information

This work was supported by the Program of Outstanding Medical Talent of Shanghai Municipal Health Bureau [grant number 2017BR034], the Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission [grant number 15SG34], and the Project of Research Doctor of Changzheng Hospital [grant number 201712]. The sponsors had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Supplementary material

701_2018_3565_MOESM1_ESM.mp4 (5.1 mb)
Online Resource 1 The video which was made at 16 weeks after the surgery. It demonstrated the stretch strength of the knee recovered after the surgery. (MP4 5213 kb)


  1. 1.
    Jones KB, Ferguson PC, Deheshi B, Riad S, Griffin A, Bell RS, Wunder JS (2010) Complete femoral nerve resection with soft tissue sarcoma: functional outcomes. Ann Surg Oncol 17(2):401–406CrossRefPubMedGoogle Scholar
  2. 2.
    Kim DH, Murovic JA, Tiel RL, Kline DR (2004) Intrapelvic and thigh level femoral nerve lesions: management and outcomes in 119 surgically treated cases. J Neurosurg 100(6):989–996CrossRefPubMedGoogle Scholar
  3. 3.
    Bertelli JA, Soldado F, Rodríguesbaeza A, Ghizoni MF (2017) Transfer of the motor branch of the abductor digiti quinti for thenar muscle reinnervation in high median nerve injuries. J Hand Surg Am 41(1):8–15CrossRefGoogle Scholar
  4. 4.
    Hu CH, Chang TN, Lu JC, Laurence VG, Chuang DC (2018) Comparison of surgical strategies between proximal nerve graft and/or nerve transfer and distal nerve transfer based on functional restoration of elbow flexion: a retrospective review of 147 patients. Plast Reconstr Surg 141(1):68e–79eCrossRefPubMedGoogle Scholar
  5. 5.
    Iorio ML, Felder JM, Ducic I (2011) Anterior branch of the obturator nerve: a novel motor autograft for complex peripheral nerve reconstruction. Ann Plast Surg 67(3):260–262CrossRefPubMedGoogle Scholar
  6. 6.
    Tsuchihara T, Nemoto K, Arino H, Amako M, Murakami H, Yoshizumi Y (2008) Sural nerve grafting for long defects of the femoral nerve after resection of a retroperitoneal tumour. J Bone Joint Surg Br 90(8):1097–1100CrossRefPubMedGoogle Scholar
  7. 7.
    Yin G, Chen H, Hou C, Xiao J, Lin H (2016) Obturator nerve transfer to the branch of the tibial nerve innervating the gastrocnemius muscle for the treatment of sacral plexus nerve injury. Neurosurgery 78(4):546–551CrossRefPubMedGoogle Scholar
  8. 8.
    Spiliopoulos K, Williams Z (2011) Femoral branch to obturator nerve transfer for restoration of thigh adduction following iatrogenic injury. J Neurosurg 114(6):1529–1533CrossRefPubMedGoogle Scholar
  9. 9.
    Goubier JN, Teboul F, Yeo S (2012) Transfer of two motor branches of the anterior obturator nerve to the motor portion of the femoral nerve: an anatomical feasibility study. Microsurgery 32(6):463–465CrossRefPubMedGoogle Scholar
  10. 10.
    Tung TH, Chao A, Moore AM (2012) Obturator nerve transfer for femoral nerve reconstruction: anatomic study and clinical application. Plast Reconstr Surg 130(5):1066–1074CrossRefPubMedGoogle Scholar
  11. 11.
    Barrett MD, Nguyen DQ, Boyce DE (2011) Intra-abdominal femoral nerve reconstruction following excision during right hemicolectomy. J Plast Reconstr Aesthet Surg 64(12):1689–1692CrossRefPubMedGoogle Scholar
  12. 12.
    Campbel AA, Eckhauser FE, Belzberg A, Campbell JN (2010) Obturator nerve transfer as an option for femoral nerve repair: case report. Neurosurgery 66(6 Suppl):375Google Scholar
  13. 13.
    Inaba N, Sato K, Suzuki T, Iwamoto T, Ochi K, Nakamura M, Matsumoto M, Toyama Y (2018) Partial obturator nerve transfer for femoral nerve injury: a case report. J Orthop Sci 23(1):202–204CrossRefPubMedGoogle Scholar
  14. 14.
    Basso DM, Beattie MS, Bresnahan JC (1995) A sensitive and reliable locomotor rating scale for open field testing in rats. J Neurotrauma 12(1):1–21CrossRefPubMedGoogle Scholar
  15. 15.
    Gang Y, Wang T, Sheng J, Hou C, Lin H (2014) Anatomical feasibility of transferring the obturator and genitofemoral nerves to repair lumbosacral plexus nerve root avulsion injuries. Clin Anat 27(5):783–788CrossRefPubMedGoogle Scholar
  16. 16.
    Houdek MT, Wagner ER, Wyles CC, Moran SL (2014) Anatomical feasibility of the anterior obturator nerve transfer to restore bowel and bladder function. Microsurgery 34(6):459–463CrossRefPubMedGoogle Scholar
  17. 17.
    Lin H, Hou C, Chen A, Xu Z (2011) Transfer of the phrenic nerve to the posterior division of the lower trunk to recover thumb and finger extension in brachial plexus palsy. J Neurosurg 114(1):212–216CrossRefPubMedGoogle Scholar
  18. 18.
    Siqueira MG, Martins RS (2009) Phrenic nerve transfer in the restoration of elbow flexion in brachial plexus avulsion injuries: how effective and safe is it? Neurosurgery 65(4 Suppl):A125–A131CrossRefPubMedGoogle Scholar
  19. 19.
    Snela S, Rydzak B (2002) The value of the adductor tenotomy with obturator neurectomy in the treatment of the hips at cerebral palsy children. Early clinical and radiological examination results. Ortop Traumatol Rehabil 4(1):11–14PubMedGoogle Scholar
  20. 20.
    Yun AG, Severino R, Reinker K (2005) Varus derotational osteotomy for spastic hip instability: the roles of femoral shortening and obturator neurectomy. Am J Orthop 34(2):81–85PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Depeng Meng
    • 1
  • Jun Zhou
    • 1
    • 2
  • Yaofa Lin
    • 1
  • Zheng Xie
    • 1
  • Huihao Chen
    • 1
  • Ronghua Yu
    • 1
  • Haodong Lin
    • 1
    Email author
  • Chunlin Hou
    • 1
  1. 1.Department of Orthopedics, Changzheng HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China
  2. 2.Department of Orthopedicsthe Second People’s Hospital of KaramayKaramayPeople’s Republic of China

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