title: Sensoric protection after median nerve injury: babysitter-procedure prevents muscular atrophy and improves neuronal recovery.
abstract: The babysitter-procedure might offer an alternative when nerve reconstruction is delayed in order to overcome muscular atrophy due to denervation. In this study we aimed to show that a sensomotoric babysitter-procedure after median nerve injury is capable of preserving irreversible muscular atrophy. The median nerve of 20 female Wistar rats was denervated. 10 animals received a sensory protection with the N. cutaneous brachii. After six weeks the median nerve was reconstructed by autologous nerve grafting from the contralateral median nerve in the babysitter and the control groups. Grasping tests measured functional recovery over 15 weeks. At the end of the observation period the weight of the flexor digitorum sublimis muscle was determined. The median nerve was excised for histological examinations. Muscle weight (P < 0.0001) was significantly superior in the babysitter group compared to the control group at the end of the study. The histological evaluation revealed a significantly higher diameter of axons (P = 0.0194), nerve fiber (P = 0.0409), and nerve surface (P = 0.0184) in the babysitter group. We conclude that sensory protection of a motor nerve is capable of preserving muscule weight and we may presume that metabolism of the sensory nerve was sufficient to keep the target muscle's weight and vitality.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Campus Forschung, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Benedicta E
authors.initials: BE
authors.lastname: Beck-Broichsitter
authors.affiliation: Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, Schleswig-Holstein, 24105 Kiel, Germany.
authors.forename: Stephan T
authors.initials: ST
authors.lastname: Becker
authors.affiliation: Clinic for Plastic Surgery with Hand and Reconstructive Microsurgery, St. Marien Hospital, Gallwitzallee 123-143, 12249 Berlin, Germany.
authors.forename: Androniki
authors.initials: A
authors.lastname: Lamia
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, 10043 Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fregnan
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, 10043 Turin, Italy.
authors.forename: Stefano
authors.identifier: 0000-0002-6962-831X
authors.initials: S
authors.lastname: Geuna
authors.affiliation: Clinic for Plastic Surgery with Hand and Reconstructive Microsurgery, St. Marien Hospital, Gallwitzallee 123-143, 12249 Berlin, Germany.
authors.forename: Nektarios
authors.initials: N
authors.lastname: Sinis
mesh_terms: D000818:Animals; D001369:Axons / Q000473:pathology; D005260:Female; D018737:Hand Strength; D008475:Median Nerve / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology*; D009133:Muscular Atrophy / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control*; D019635:Neurosurgical Procedures / Q000379:methods*; D009929:Organ Size; D017208:Rats, Wistar; D020127:Recovery of Function; D012677:Sensation