Author/Authors :
Kamal Frutan, Saeid Dept of Surgery - Tehran University of Medical Sciences , Salehi, Hossein Department of Surgery - Rafsanjan University of Medical Sciences, Rafsanjan-Iran , Mansouri, Korosh Tehran University of Medical Sciences , Bakhtyari, Mehrdad Dept of Anatomy, Tehran University of Medical Sciences , Abootaleb, Hamid Tehran University of Medical Sciences , Pedram, Sepehr Tehran University of Medical Sciences
Abstract :
Background: Although, different studies on end-to-side nerve repair, results are controversial. The importance
of this method in case is unavailability of proximal nerve. In this method, donor nerves also remain intact and
without injury. In compare to other classic procedures, end-to-side repair is not much time consuming and needs
less dissection. Overall, the previous studies in this field have just evaluated nerve recovery by non functional or
functional parameters. As it has proven, the results of functional and non functional studies are not always
matched. Therefore, this study was designed to evaluate this method by functional (Sciatic function index) and
non functional parameters (histochemical study).
Methods: In this experimental study, forty adult male Wistar rats (200-250g) were used their left proneal nerve
was cut and divided into four groups: 1- control group (n=10). In this group, nerve was exposed and cut and
implanted onto adductor muscles, 2- end-to-end anastomosis (n=10). In this group, peroneal nerve cut and two
segments were anastomosed end-to-end, 3- end-to-side anastomosis with window (n=10). In this group, peroneal
nerve was cut and anastomosed with window to tibial nerve, 4- end-to-side anastomosis without window
(n=10). In this group, peroneal nerve was cut and anastomosed without window to tibial nerve. After 1, 8 and 16
weeks, functional (Sciatic function index) and after 16 weeks non functional studies (histochemical study) were
performed and the results compared.
Results: All experimental groups (group 2, 3, 4) motor recovery at 8th, 16th week were not statistically different
(p>0.05). In histological study axons count in end -to-side with window anastomosis were higher than other
experimental groups (p<0.05).
Conclusion: According to our findings, the authors believe that end to side neuroraphy leads to axon growth
and comparable functional recovery with end to end neuroraphy in rat model. Due to the fact that the diameter
of nerves and muscles which might be neurotised in human are much bigger and not comparable with rat, it is
suggested to set up some set of experiments on the bigger size animals such as primates in further studies for
generalization of results to human being.
Keywords :
histologic study , motor recovery , end-to-end nerve anastomosis , end-to-side nerve anastomosis
