Evaluation of Sensory Deficit in Foot Following Sural Nerve Graft

Abstract

Abstract: Background: The sural nerve is the most commonly used donor nerve for autologous nerve grafts in reconstructive surgery. The functional outcomes may be impacted with harvest of SNG as it may lead to sensory deficit at donor site.

Objective: To evaluate sensory deficit and patients’ experiences of functional impairment after sural nerve graft.

Materials and Methods: The present prospective observational study was performed in Plastic & Reconstructive Surgery Department of Dr. KM Ruth Pfau Civil Hospital during 1st August 2024 to 28th February 2025. This study received approval from the Institutional Review Board (IRB) at the Dow University of Health Sciences with reference number IRB-3502/DUHS/Approval/2024/176. Sensory examination was performed via Semmes-Weinstein monofilaments. Patients were also asked to report their experience regarding postoperative discomfort, sensory deficits, pain, cold intolerance, and their effect on daily activities, sleep, work, and leisure.

Result: A total of 73 patients were studied with median age of 41 (IQR=26.5-49) years. Some of the patients achieved sensation of 0.5g (30.1%). Majority of patients (42.5%) had mild sensory deficit with who achieved 2.0 g sensation. Around quarter of patients had moderate to profound sensory loss (27.4%). Absence of sensation was not seen in any of the patient. Few patients reported any discomfort in their foot (16.4%), loss of sensation (12.3%), pain in operated leg (11%), cold intolerance (9.6%), sensory deficit effecting daily life (9.6%), sleep (9.6%), work or their attendance (11%) and leisure activities (15.1%).

Conclusion: The findings of present study suggested that according to monofilament examination system nearly a quarter of patients had moderate to severe sensory deficit. However, a smaller proportion of patients reported that their functional activities were impacted substantially after sural nerve graft.