Comparison of Peripheral Nerve Regeneration with Side-to-side, End-to-side, and End-to-end Repairs: An Experimental Study.

Plast Reconstr Surg Glob Open

Department of Orthopaedics, Hatanpää City Hospital, Tampere, Finland; Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland; Department of Hand Surgery, Turku University Hospital, Turku, Finland; and §Institute of Clinical Medicine, Department of Biostatistics, and Department of Pathology/ Neuropathology, Turku University Hospital, University of Turku, Turku, Finland.

Published: December 2016

Background: The present study was conducted to find out a tool to enable improved functional recovery with proximal nerve injury. In this experimental study, nerve regeneration was compared between side-to-side (STS), end-to-side (ETS), and end-to-end repairs.

Methods: The walk track analysis was used as an outcome of functional recovery. Nerve regeneration was studied with morphometry and histology 6 or 26 weeks postoperatively.

Results: All 3 repair techniques showed regeneration of the nerve. From 12 weeks onward, the functional results of the 3 intervention groups were significantly better compared with the unrepaired control group. End-to-end repair was significantly better when compared with the STS and ETS groups. At 26 weeks, the functional and morphometric results and histologic findings did not differ between the STS and ETS groups. The functional results correlated with the morphometric findings in all groups.

Conclusions: STS neurorrhaphy showed nerve regeneration, and the end results did not differ from clinically widely used ETS repair. Further studies are warranted to optimize the neurorrhaphy technique and examine possible applications of STS repair in peripheral nerve surgery.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222668PMC
http://dx.doi.org/10.1097/GOX.0000000000001179DOI Listing

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