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End-to-side nerve grafting of the tibial nerve to bridge a neuroma-in-continuity

✍ Scribed by James M. Kerns; Eduard H. Sladek; Tejashree S. Malushte; Harold Bach; Bassem El-hassan; Pravit Kitidumrongsook; Jeffrey S. Kroin; Susan Shott; George Gantsoudes; Mark H. Gonzalez

Publisher
John Wiley and Sons
Year
2005
Tongue
English
Weight
250 KB
Volume
25
Category
Article
ISSN
0738-1085

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✦ Synopsis

Standard treatment for a neuroma-in-continuity with partial retained function is neurolysis with or without grafting. The present study tests the outcome of a novel partial nerve lesion bypassed with an end-to-side bridge graft, intended to increase the number of axons crossing the defect while not disturbing intact axons. An 8-mm portion of tibial nerve was resected in 20 rats. Three weeks later, half had the defect repaired with an end-to-side bridge allograft and perineurial windows; controls had only neurolysis. Recovery was evaluated using walkingtrack analysis, allodynia testing, muscle weight ratios, and histology at 8 weeks. No significant differences in motor or sensory functional recovery were noted between the two groups. Histology showed good axonal regeneration through the defect in all specimens. The experimental group also had regenerated axons in the bridge graft, but their maturity was less advanced, presumably due to delays in regeneration.

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