title: Can the Babysitter Procedure Improve Nerve Regeneration and Denervated Muscle Atrophy in the Treatment of Peripheral Nerve Injury?
abstract: BACKGROUND
  The authors evaluated the long-term efficacy of the "babysitter" procedure in improving nerve regeneration and denervated muscle atrophy for peripheral nerve repair.
  
  
  METHODS
  Eighty Lewis rats were allocated equally into four groups. The peroneal nerves of all animals were divided. In group A, the peroneal nerve stumps were anchored into adjacent muscles. Rats in group B underwent end-to-end neurorrhaphy. Rats in group C underwent end-to-side neurorrhaphy of the distal peroneal nerve stump to an epineurial window on the tibial nerve. Rats in group D underwent end-to-side neurorrhaphy of the distal stump to the tibial nerve with 40 percent neurectomy. After 8 weeks, end-to-end neurorrhaphy of the peroneal nerve stumps was performed in group A, C, and D during a second-stage procedure. Electrophysiology, myelinated fiber counts, muscle force and weight, and muscle histomorphometry were analyzed at 4, 8, 12, and 24 weeks postoperatively.
  
  
  RESULTS
  At 4 weeks, the end-to-end group showed predominant advantages in nerve regeneration and muscle preservation. No differences were observed in the latency delaying rate, tetanic tension, myelinated fiber number, or muscle weight between groups B and D by 24 weeks (p > 0.05). At 24 weeks, the results revealed superior latency delaying rate, myelinated axon regeneration, and size of muscle fibers in group D as compared with group C.
  
  
  CONCLUSIONS
  Peripheral nerve repair with an initial motor nerve babysitter with 40 percent neurectomy of the donor nerve can achieve high efficacy in functional and structural recovery of the recipient system. Nerve babysitter by motor nerve with an epineural window was less effective.
authors.affiliation: Shandong and Shanghai, People's Republic of China; and Jackson, Miss.|From the Department of Orthopedic Surgery, the Affiliated Hospital of Qingdao University; the Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University; and the Joseph M. Still Burn and Reconstructive Center.
authors.forename: Hai-Fei
authors.initials: HF
authors.lastname: Liu
authors.affiliation: Shandong and Shanghai, People's Republic of China; and Jackson, Miss.|From the Department of Orthopedic Surgery, the Affiliated Hospital of Qingdao University; the Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University; and the Joseph M. Still Burn and Reconstructive Center.
authors.forename: Zeng-Gan
authors.initials: ZG
authors.lastname: Chen
authors.affiliation: Shandong and Shanghai, People's Republic of China; and Jackson, Miss.|From the Department of Orthopedic Surgery, the Affiliated Hospital of Qingdao University; the Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University; and the Joseph M. Still Burn and Reconstructive Center.
authors.forename: William C
authors.initials: WC
authors.lastname: Lineaweaver
authors.affiliation: Shandong and Shanghai, People's Republic of China; and Jackson, Miss.|From the Department of Orthopedic Surgery, the Affiliated Hospital of Qingdao University; the Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University; and the Joseph M. Still Burn and Reconstructive Center.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002452:Cell Count; D004195:Disease Models, Animal; D004576:Electromyography; D009119:Muscle Contraction / Q000502:physiology; D009133:Muscular Atrophy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D009416:Nerve Regeneration / Q000502:physiology*; D019635:Neurosurgical Procedures / Q000379:methods*; D059348:Peripheral Nerve Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D010543:Peroneal Nerve / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D051381:Rats; D011917:Rats, Inbred Lew; D013979:Tibial Nerve / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology