RSS-Feed abonnieren
DOI: 10.1055/s-2005-862780
Reverse End-to-Side Neurotization
Publikationsverlauf
Publikationsdatum:
26. Januar 2005 (online)
ABSTRACT
The authors describe a reverse end-to-side neurorrhaphy model in which the proximal end of a donor nerve is sutured to an epineurial window in the side of a recipient nerve. If effective, this technique would have useful applications in nerve reconstructive surgery. Female Sprague-Dawley rats were divided into three groups (n = 9). In Group A, the peroneal nerve was transected and directly repaired in standard end-to-end fashion. In Group B, the tibial nerve was transected and the proximal end was sutured to the side of the intact peroneal nerve through an epineurial window. In Group C, the tibial nerve was also transected and the proximal end sutured to the side of the intact peroneal nerve, but the peroneal nerve was then cut proximally. After 12 weeks, contractile forces of the extensor digitorum communis (EDC) were measured, following stimulation of the proximal sciatic nerve on all experimental (and normal) hind limbs. For Group B, the peroneal nerve was transected proximal to the repair site just prior to stimulation. Group B animals did not demonstrate any measurable contractions. No statistically significant differences were found between Groups A and C. This demonstrated the successful neurotization of a denervated muscle using a reverse end-to-side neurorrhaphy model.
KEYWORDS
Peripheral nerve injury - nerve repair - neurotization
REFERENCES
- 1 Rydevik B, Lundborg G, Nordborg C. Intraneural tissue reactions induced by internal neurolysis. An experimental study on the blood-nerve barrier, connective tissues and nerve fibers of rabbit tibial nerve. Scand J Plast Reconstr Surg. 1976; 10 3-8
- 2 Gentili F, Hudson A R, Kline D G, Hunter D A. Morphological and physiological alterations following internal neurolysis of normal rat sciatic nerve. In: Gorio A, Millesi H, Mingrino S Posttraumatic Peripheral Nerve Regeneration: Experimental Basis and Clinical Implications. New York, NY; Raven Press 1981: 183-210
- 3 Goth D. Animal experiment studies of neurolysis of peripheral nerves [in German]. Handchir Mikrochir Plast Chir. 1987; 19 212-216
- 4 Gilbert A, Hentz V R, Tassin J L. Brachial plexus reconstruction in obstetric palsy: operative indications and postoperative results. In: Urbaniak JR Microsurgery for Major Limb Reconstruction. St. Louis, MO; CV Mosby 1987: 348-364
- 5 Seddon H. Nerve grafting. J Bone Joint Surg. 1963; 45B 447-461
- 6 Viterbo F, Trindade J C, Hoshino K et al.. Two end-to-side neurorrhaphies and nerve graft with removal of the epineurial sheath: experimental study in rats. Br J Plast Surg. 1994; 47 75-80
- 7 Lundborg G, Zhao Q, Kenje M et al.. Can sensory and motor collateral sprouting be induced from intact peripheral nerve by end-to-side anastomosis?. J Hand Surg. 1994; 19B 277-282
- 8 Shah M H, Kasabian A K, Karp N S et al.. Axonal regeneration through an autogenous nerve bypass: an experimental study in the rat. Ann Plast Surg. 1997; 38 408-415
- 9 McCallister W V, Cober S R, Norman A, Trumble T E. Using intact nerve to bridge peripheral nerve defects: an alternative to the use of nerve grafts. J Hand Surg. 2001; 26A 315-325
- 10 Liu K, Chen L E, Seaber A V et al.. Motor functional and morphological findings following end-to-side neurorrhaphy in the rat model. J Ortho Res. 1999; 17 293-300
- 11 Chen Y G, Brushart T M. The effect of denervated muscle and Schwann cells on axon collateral sprouting. J Hand Surg. 1998; 23A 1025-1033
Jonathan IsaacsM.D.
Department of Orthopedic Surgery, Virginia Commonwealth University
1200 E. Broad Street, P.O. Box 980153
Richmond, VA 23298-0153