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Early muscle reinnervation by means of end-to-side neurorrhaphy in an experimental model

Plastic and Aesthetic Research 2017年第2期4卷 18-23页

作者： AraceIi Pérez rafaei reynoso Rosa MRomero AngéIica GonzáIez Jorge Ochoa DuIce HGutiérrez Damián PaIafox Department of Plastic Surgery General Hospital“Dr.Manuel Gea Gonzalez”Mexico City14080Mexico Department of Morphology of Cell and Tissue National Pediatric InstituteMexico City14080Mexico Department of Plastic Surgery Hospital AngelesMexico City14080Mexico Department of Health Sciences Technological University of MexicoMexico City14080Mexico.

Aim:The aim of the study was to provide early muscular reinnervation to avoid muscle atrophy and functional loss in an experimental ***:Fifty rats were divided into five *** group 0(control group)only nerve dissection was *** peroneal nerve section was performed in the remaining *** end-to-end neurorrhaphy(EEN)was made in group *** group 2,an end-to-side neurorrhaphy(ESN)was performed from the tibial nerve to the peroneal *** group 3,a direct EEN,plus an ESN,were used as a nerve graft as a bridge from the donor nerve(tibial);all nerve coaptations were performed through an epineural *** group 4,only a neurotomy was made without any type of ***:Neural diameters were similar in groups 0,1,and 3(38±1μm,31±6μm,32±3μm).Neural fibers in group 3 had an 18%increase in the number of axons(P<0.001)when compared to group *** 2(28±1μm)and group 4(19±3μm)had diminished diameters with a lower index of muscle *** in group 4 presented with'clawed'lower extremities and had difficulty with *** graft diameters was similar in groups 2 and 3(33±4μm,31±3μm),but axon density was significantly higher in group 3(53±6μm,39±8μm)(P<0.001).Axon density was 36%higher when the combination of EEN and ESN with a neural graft through an epineural window was ***:This study revealed that the combination of EEN and ESN repairs with the addition of a neural graft provides a lower index of muscle fiber destruction,and can be a reliable method for reconstruction in high neural injuries.

关键词： Nerve transfer neurorrhaphy muscle reinnervation nerve repair

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