End-to-side versus end-to-end neurorrhaphy at the peroneal nerve in rats

Fausto Viterbo,Benoit Ayestaray,Ryane Schmidt Brock,Fábio Maciel,José Antonio Garbino,Cecília Pessoa Rodrigues

doi:10.1590/s0102-865020170090000002

Abstract

To evaluate three different kinds of neurorrhaphy of the peroneal nerve. Eigthy rats were divided into 5 groups. Control: nerve had no intervention. End-to-end (EE): nerve was cut and elongated with a nerve graft with two end-to-end neurorrhaphies. End-to-side (ES): nerve was cut and sutured to the graft with at the lateral side of the nerve. Side-to-end (SE): the nerve was cut and sutured to the graft with end-to-end neurorrhaphy. Denervated: nerve was cut and both endings were buried into the muscle. The evaluation was done by walking track analysis, electrophysiology, body mass, cranial tibial muscle mass, nerve and muscle fibers morphometry. The EE, ES and SE have the same potential of reinnervation. There is no functional or histological difference between these different types of neurorrhaphy.

Highlights

Peripheral nerve can have inflammatory, traumatic, metabolic, toxic, genetic and neoplastic diseases, which develops different types and grades of nerve lesions
The cranial tibial muscle mass was measured and analysed by Kruskal-Wallis test. It demonstrated a higher mass in the control group and similar results in EE, ES and SE groups
Parametric analysis of amplitude variance with Tukey test demonstrated statistical higher values in control group compared to EE and denervated groups

Summary

Introduction

Peripheral nerve can have inflammatory, traumatic, metabolic, toxic, genetic and neoplastic diseases, which develops different types and grades of nerve lesions. To repair peripheral nerve injuries the end-toend neurorrhaphy (EE) is frequently used connecting the proximal to the distal ending. A choice to avoid donor nerve morbidity is the side-to-end (SE) or end-toside (ES) neurorrhaphy proposed by Viterbo et al.[2,3,4]. These authors demonstrated the reinnervation of the cranial tibial muscle in rats after a suture between the distal ends of the peroneal nerve to the lateral side of the tibial nerve. Other authors used this technique; all of them did a partial incision at the donor nerve, connecting endoneural tubes between donor and receptor nerves in an end-to-end model. Harming the donor nerve led to functional problems[6,7,8,9,10,11]

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