Clin Orthop Surg.  2009 Jun;1(2):90-95. 10.4055/cios.2009.1.2.90.

Contribution of the Proximal Nerve Stump in End-to-side Nerve Repair: In a Rat Model

• Jung JM
• Chung MS
• Kim MB
• Baek GH

• KMID: 1122638
• DOI: http://doi.org/10.4055/cios.2009.1.2.90

Abstract

BACKGROUND: The aim of this study was to evaluate the contribution of the proximal nerve stump, in end-to-side nerve repair, to functional recovery, by modifying the classic end-to-side neurorrhaphy and suturing the proximal nerve stump to a donor nerve in a rat model of a severed median nerve.
METHODS
Three experimental groups were studied: a modified end-to-side neurorrhaphy with suturing of the proximal nerve stump (double end-to-side neurorrhaphy, Group I), a classic end-to-side neurorrhaphy (Group II) and a control group without neurorrhaphy (Group III). Twenty weeks after surgery, grasping testing, muscle contractility testing, and histological studies were performed.
RESULTS
The grasping strength, muscle contraction force and nerve fiber count were significantly higher in group I than in group II, and there was no evidence of nerve recovery in group III.
CONCLUSIONS
The contribution from the proximal nerve stump in double end-to-side nerve repair might improve axonal sprouting from the donor nerve and help achieve a better functional recovery in an end-to-side coaptation model.

Keyword

Median nerve; Proximal stump; Peripheral nerve injury; End-to-side neurorrhaphy; Nerve recovery

MeSH Terms

Anastomosis, Surgical/methods
Animals
Axons/pathology
Forelimb
Hand Strength
Male
Median Nerve/pathology/*surgery
Muscle Contraction
Muscle, Skeletal/physiopathology
Nerve Regeneration
Nerve Transfer/*methods
Rats
Rats, Sprague-Dawley
Recovery of Function
Ulnar Nerve/pathology/*surgery

Figure

• 

  Fig. 1 A rat underwent a grasping strength test. The animal was gently lifted by the tail and allowed to grasp the grid connected to an electronic balance. While grasping, the rat continued to be lifted by the tail with increasing firmness until it loosened its grip. At that precise moment, the negative value demonstrated by the balance was recorded.

• 

  Fig. 2 Schematic drawing of the end-to-side neurorrhaphy in Group I and Group II. MN: Median nerve, UN: Ulnar nerve.

• 

  Fig. 3 Photomicrographs of the cross-section in Group I. (A) Site A. Average number of the myelinated nerve fibers was 1760 ± 310. (B) Site B. Average number of the myelinated nerve fibers was 1205 ± 233. Regenerated nerve fibers were more compact with increased axonal size than in Group II-site B. (C) Site C. Average number of the myelinated nerve fibers was 1713 ± 341. (D) Site D. Average number of the myelinated nerve fibers was 1643 ± 215. (E) Site A'. Average number of the myelinated nerve fibers was 1958 ± 209 (Toluidine blue, × 200).

• 

  Fig. 4 Photomicrographs of the cross-section in Group II. (A) Site A. Average number of the myelinated nerve fibers was 1895 ± 213. (B) Site B. Average number of the myelinated nerve fibers was 536 ± 184. (C) Site C. Average number of the myelinated nerve fibers was 1800 ± 264 (Toluidine blue, × 200).

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