title: End-to-end versus end-to-side motor and sensory neurorrhaphy in the repair of the acute muscle denervation.
abstract: BACKGROUND
  The aim of this study was to experimentally compare end-to-end and end-to-side neurorrhaphy in perineural window model after motor nerve lesion, evaluating which one was the most effective to preserve nerves. Also, differences in motor and sensorial nerve regeneration were tested to verify differences in nerve regeneration.
  
  
  METHODS
  A total of 20 adult male Wistar rats were randomly assigned to 5 groups, and, in each one, a different treatment was performed: besides the control group, and end-to-end or end-to-side graft with motor or sensorial nerves was performed. Silastic sheet was used as a mechanical barrier to prevent innervation from adjacent nerves. After 16 weeks, the specimens were histologically assessed and wet weight was evaluated as a direct parameter of atrophy.
  
  
  RESULTS
  The end-to-end neurorrhaphy group presented the best results in terms of mass preservation, but it did not differ significantly from the control group. Motor nerves presented similar results in muscular atrophy. The end-to-side neurorrhaphy group with sensory nerve as donor showed the worst results.
  
  
  CONCLUSIONS
  The use of sensory nerves to preserve skeletal muscle trophism is not justified, since, according to our model, it affects 50% to 80% of the muscle mass in a period of 16 weeks. End-to-side neurorrhaphy was demonstrated to be an option for re-enervation of a nerve-deprived motor muscle in selected cases.
authors.affiliation: Laboratory of Surgical Technique and Microsurgical Research, Department of Hand Surgery and Reconstructive Microsurgery, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. marcosjaeger@novaplastia.com
authors.forename: Marcos Ricardo de Oliveira
authors.initials: MR
authors.lastname: Jaeger
authors.forename: Jefferson
authors.initials: J
authors.lastname: Braga-Silva
authors.forename: Daniel
authors.initials: D
authors.lastname: Gehlen
authors.forename: Gustavo de Azambuja
authors.initials: Gde A
authors.lastname: Pereira-Filho
authors.forename: Claudio Galleano
authors.initials: CG
authors.lastname: Zettler
authors.forename: Maria Antonieta Lopes
authors.initials: MA
authors.lastname: de Souza
authors.forename: Javier Román
authors.initials: JR
authors.lastname: Veas
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sebben
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D008297:Male; D009046:Motor Neurons / Q000502:physiology; D009121:Muscle Denervation; D018482:Muscle, Skeletal / Q000294:innervation* / Q000473:pathology / Q000637:transplantation; D009133:Muscular Atrophy / Q000209:etiology / Q000517:prevention & control; D009416:Nerve Regeneration; D009475:Neurons, Afferent / Q000502:physiology; D059348:Peripheral Nerve Injuries / Q000209:etiology / Q000601:surgery*; D010525:Peripheral Nerves / Q000637:transplantation*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000294:innervation* / Q000473:pathology; D013979:Tibial Nerve / Q000502:physiology / Q000601:surgery