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DOI: 10.1055/s-2007-1000144
© 1999 by Thieme Medical Publishers, Inc.
Is End‐to‐Side Neurorrhaphy Effective? A Study of Axonal Sprouting Stimulated from Intact Nerves
Publication History
Accepted for publication 1999
Publication Date:
08 March 2008 (online)
![](https://www.thieme-connect.de/media/jrm/199908/lookinside/thumbnails/10.1055-s-2007-1000144-1.jpg)
ABSTRACT
The purpose of this study was to determine if axonal sprouting across an end-to-side coaptation could be stimulated and if so, to identify the source of the regenerating axons. Mechanical trauma, the method used to stimulate axonal sprouting, was compared to a control group with coaptation only and an additional non-grafted control group. After a 20-week recovery period, electrical stimulation revealed that the target muscles had been reinnervated in all groups except the non-grafted control group. Axonal counting demonstrated a significant increase for the mechanical trauma group compared to the control group with coaptation only [ratio of the density of axons/μm2 of the experimental to the contralateral control side: 2.78 ± 0.11 vs. 0.96 ± 0.15, respectively, p < 0.002]. Tibialis anterior muscle weights were significantly increased for both groups vs. the non-grafted control group [ratio of experimental to the contralateral control side: coaptation-only control, 0.539 ± 0.024; mechanical trauma, 0.538 ± 0.036 vs. non-grafted control, 0.220 ± 0.003, p < 0.002]. Of importance, this study provides evidence that the intact tibial nerve functions as a bridge for regenerating axons derived from the proximal peroneal stump. This suggests an alternative explanation to successful end-to-side axonal sprouting, and questions the clinical utility of end-to-side coaptation.