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J Reconstr Microsurg 2015; 31(01): 031-038
DOI: 10.1055/s-0034-1382263
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Efficacy of the End-to-Side Neurorrhaphies with Epineural Window and Partial Donor Neurectomy in Peripheral Nerve Repair: An Experimental Study in Rats

Hai-Fei Liu
1   Department of Orthopedic Surgery, the Affiliated Hospital of Medical College, Qingdao University, Shandong, China
2   Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
*   Hai-Fei Liu and Han Zhang contributed equally to this work and should be considered co-first authors.
,
Zeng-Gan Chen
2   Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
,
Hai-Min Shen
3   Department of Orthopedic Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China
,
Han Zhang
4   Department of Internal Medicine, the Affiliated Hospital of Medical College, Qingdao University, Shandong, China
*   Hai-Fei Liu and Han Zhang contributed equally to this work and should be considered co-first authors.
,
Jian Zhang
2   Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
,
William C. Lineaweaver
5   JMS Burn and Reconstructive Center, Jackson, Mississippi
,
Feng Zhang
2   Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
6   Division of Plastic Surgery, University of Mississippi, Jackson, Mississippi
› Author Affiliations
Further Information

Publication History

15 December 2013

16 April 2014

Publication Date:
01 August 2014 (online)

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Abstract

Background End-to-side (ETS) neurorrhaphy was a useful tool in peripheral nerve repair and “baby-sitter” procedure. The study was designed to evaluate the long-term efficacy of ETS with epineurial window and 40% partial donor neurectomy in rats.

Materials and Methods A total of 60 Lewis rats were divided into three groups (n = 20, each group): following peroneal nerve transection, rats in Group A underwent end-to-end neurorrhaphy; rats in Group B underwent ETS neurorrhaphy of the distal peroneal nerve stump to an epineurial window on the tibial nerve; and rats in Group C underwent ETS neurorrhaphy of the distal peroneal nerve stump to the tibial nerve with 40% partial neurectomy. At 6, 12, 18, and 24 weeks after surgery, electrophysiology, muscle tension, myelinated fiber regeneration, cross-sectional area of muscular fiber, and muscle weight were analyzed.

Results Histology exhibited apparently increased number and size of myelinated fibers in peroneal nerves in Group C, compared with those in Group B. More superior recovery was demonstrated in the electrophysiology and axon regeneration of the peroneal nerves, as well as the maintenance of muscle force, wet weight, and fiber size of the anterior tibial muscles in Group C than those in Group B.

Conclusion ETS neurorrhaphy with partial donor neurectomy can achieve higher efficacy in functional and structural recovery of the recipient system. This study provides the evidence of long-term follow-up for the further investigation of ETS neurorrhaphies with different modalities in peripheral nerve repair and in “baby-sitter” procedure.

Keywords

end-to-side neurorrhaphy - epineurial window - neurectomy
 

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