End-to-side nerve grafting of the tibial nerve to bridge a neuroma-in-continuity.
Standard treatment for a neuroma-in-continuity with partial retained function is neurolysis with or without grafting. The present study tests the outcome of a novel partial nerve lesion bypassed with an end-to-side bridge graft, intended to increase the number of axons crossing the defect while not disturbing intact axons. An 8-mm portion of tibial nerve was resected in 20 rats. Three weeks later, half had the defect repaired with an end-to-side bridge allograft and perineurial windows; controls had only neurolysis. Recovery was evaluated using walking-track analysis, allodynia testing, muscle weight ratios, and histology at 8 weeks. No significant differences in motor or sensory functional recovery were noted between the two groups. Histology showed good axonal regeneration through the defect in all specimens. The experimental group also had regenerated axons in the bridge graft, but their maturity was less advanced, presumably due to delays in regeneration.
Kerns
James M
JM
Department of Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Street, Chicago, IL 60612, USA.
Sladek
Eduard H
EH
Malushte
Tejashree S
TS
Bach
Harold
H
Elhassan
Bassem
B
El-Hassan
Bassem
B
Kitidumrongsook
Pravit
P
Kroin
Jeffrey S
JS
Shott
Susan
S
Gantsoudes
George
G
Gonzalez
Mark H
MH
D000818:Animals; D001369:Axons / Q000502:physiology; D005260:Female; D005684:Gait; D023421:Models, Animal; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D009463:Neuroma / Q000601:surgery*; D010543:Peroneal Nerve / Q000637:transplantation; D051381:Rats; D011916:Rats, Inbred F344; D013979:Tibial Nerve / Q000601:surgery*