Effect of mobilization on the blood supply and regeneration of injured nerves

Abstract

Both tibial nerves were partially crushed in 6 monkeys, completely crushed in 10, severed and sutured in 12, and left intact in 4. Evoked nerve action potentials and electromyograms were monitored to document the extent of injury. The nerve on one side was then completely mobilized while the opposite nerve was not mobilized. At an interval from 1 to 52 weeks later, electrical studies were repeated and extremities perfused for x-ray studies of the nerve vasculature. Mobilized and injured nerves kept electrical and histologic pace with those nerves injured but not mobilized. Postinjury conduction velocities and nerve action potential amplitudes were comparable in both series. Patterns of revascularization were identical except in the early weeks after injury where a larger quantity of both collateral and intraneural vessels was seen in the nonmobilized nerves than in those mobilized. Mobilization of acutely injured nerves should be minimal but, from these studies, appears safe since functional regeneration does not depend on the initial preservation of collateral blood supply.