title: The cut intramuscular nerve affects the recovery in the lacerated skeletal muscle.
abstract: The recovery of lacerated skeletal muscles are said to be slow and incomplete. Often the intramuscular (IM-) nerve is concomitantly cut, but never repaired. We questioned whether the IM-nerve should also be reanastamosed before repairing the skeletal muscle. Before answering this, it was necessary to know if the cut IM nerve would have an effect on the recovery of the segment of muscle distal to the level of the laceration. This study investigates the recovery of lacerated muscles after repair, and compares a complete muscle laceration where the main IM-nerve was concomitantly cut and an incomplete muscle laceration where the IM-nerve was preserved intact. The medial gastrocnemius (MG) of the adult male New Zealand White rabbit was used, with the contralateral muscle as a sham control. The laceration was at the proximal quarter of the muscle, distal to the entry point of the nerve branch from the tibial nerve into the muscle belly. Twenty-eight weeks post-repair, the lacerated MG with the IM-nerve intact showed improved muscle wet weight, near normal morphology and contractile properties, and return of muscle fiber type mix and size. The repaired lacerated MG with their IM-nerve concomitantly cut demonstrated loss of muscle wet weight, obvious fibrosis, mononuclear proliferation with fatty infiltration, increase in type-1 fibers and muscle fiber atrophy in the distal portion. We postulate that it might be important to repair the intramuscular nerve branch by microanastomosis when repairing a vital skeletal muscle that is lacerated.
authors.affiliation: Musculoskeletal Research Laboratories, Department of Orthopaedic Surgery, National University of Singapore, 10 Kent Ridge Crescent, Singapore 119260, Singapore. dosbarry@nus.edu.sg
authors.forename: Barry P
authors.initials: BP
authors.lastname: Pereira
authors.forename: Jessie A C
authors.initials: JA
authors.lastname: Tan
authors.forename: Ling
authors.initials: L
authors.lastname: Zheng
authors.forename: Bee-Leng
authors.initials: BL
authors.lastname: Tan
authors.forename: Amitabha
authors.initials: A
authors.lastname: Lahiri
authors.forename: Aymeric Y T
authors.initials: AY
authors.lastname: Lim
authors.forename: V Prem
authors.initials: VP
authors.lastname: Kumar
mesh_terms: D000818:Animals; D004558:Electric Stimulation; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D018485:Muscle Fibers, Skeletal / Q000473:pathology; D018482:Muscle, Skeletal / Q000293:injuries* / Q000294:innervation* / Q000473:pathology; D011817:Rabbits; D013979:Tibial Nerve / Q000293:injuries; D014945:Wound Healing