title: Stump rotation in a nerve autograft by 2 factors: cross-connection and difference in diameter.
abstract: The aim of this study was to determine the influence of stump rotation (fascicular cross-connection) on nerve autograft functional recovery. Thirty rat sciatic nerves were transected and repaired by autograft. The rats were divided into 3 groups according to the number of stump rotations of the autograft: (1) plain graft (PG-g, with no change in fascicular orientation, no difference in diameter), (2) graft rotation (GR-g, with no change in fascicular orientation, and diameter difference between fascicles), (3) stump rotation (SR-g, with cross-connection and diameter difference between fascicles). Relative gastrocnemius muscle weight and nerve fiber count were examined as anatomic recovery indices, and autotomy score (ATS) and toe-out angle as functional recovery indices. The results showed that SR-g had a significantly low functional recovery compared with PG-g and GR-g. However, there was no difference found in the anatomic recovery. These findings suggest that the stump rotation in nerve autograft had no effect on neural regeneration and muscle reinnervation; however, it had a negative effect on functional recovery. Because GR-g was similar to PG-g rather than SR-g in functional recovery, the diameter difference between fascicles appears to have had little effect on the functional recovery. The results of this study suggest that a novel approach to ATS interpretation is needed. It is recommended that (1) ATS 2 be considered the onset of autotomy instead of ATS 1; and (2) the frequency of "ATS 2 and above" should be considered for the comparison of the autotomy rather than the mean ATS.
authors.affiliation: Inha Research Institute for Medical Science, School of Medicine, Inha University, Incheon, Korea.
authors.forename: Nuri Hyun
authors.initials: NH
authors.lastname: Jung
authors.forename: Kun
authors.initials: K
authors.lastname: Hwang
authors.forename: Seho
authors.initials: S
authors.lastname: Hwang
mesh_terms: D000818:Animals; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation; D009416:Nerve Regeneration / Q000502:physiology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D012399:Rotation; D012584:Sciatic Nerve / Q000293:injuries / Q000601:surgery*; D013536:Suture Techniques; D014182:Transplantation, Autologous