End-to-side neurorrhaphy supported by transposed active nerve fibers: its functional end result in a rat model

Abstract

End-to-side nerve repair is an old-fashioned technique which has been abandoned since the beginning of this century. Recently, new treatment modalities have been investigated to overcome problems associated with peripheral nerve injury where the proximal stumps are not available. In this study, 30 rats were divided into three groups. In the first group the peroneal nerves were sectioned and their distal ends were sutured to the tibial nerve trunk. In the second group, the proximal part of the peroneal nerve was similarly sutured to the tibial trunk. A primary end-to-end neurorrhaphy performed on the peroneal nerves was the control group. At 2, 4, 8, 12, 20, and 28 weeks, functional assessment of nerve regeneration was performed using walking track analysis. The number of myelinated fibers and fiber diameters were measured, and an electron microscopic evaluation was carried out. With morphometric analysis, the values were significantly different in favor of the control group following the end-to-side repair technique. But, according to gait analysis, both groups had a similar satisfactory functional recovery; the classic end-to-side repair group had an unsatisfactory result. It is concluded that end-to-side neurorrhaphy, supported by transposed active nerve fibers, may result in a good integration network at the repair site and is a possible functional reconstruction model where the proximal stump is not available after peripheral nerve injury.