Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves
IntroductionPeripheral nerve defect is a difficult disease to treat in clinical practice. End-to-side anastomosis is a useful method to treat it. At present, the end-to-side anastomosis method does not involve the proximal nerve, which results in a waste of proximal donor nerves, and even the format...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1088983/full |
| _version_ | 1797851370859003904 |
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| author | Dongdong Li Qi Yang Xin Liu Jing Jia Guangbo Liu Kewen Bai Shicheng Jia Jun Peng Fei Yu Fei Yu |
| author_facet | Dongdong Li Qi Yang Xin Liu Jing Jia Guangbo Liu Kewen Bai Shicheng Jia Jun Peng Fei Yu Fei Yu |
| author_sort | Dongdong Li |
| collection | DOAJ |
| description | IntroductionPeripheral nerve defect is a difficult disease to treat in clinical practice. End-to-side anastomosis is a useful method to treat it. At present, the end-to-side anastomosis method does not involve the proximal nerve, which results in a waste of proximal donor nerves, and even the formation of traumatic neuromas at the proximal end. The patients suffer from traumatic neuralgia and the curative effect is unsatisfactory.MethodsIn this study, an improved end-to-side anastomosis technique was proposed in this study: both the proximal and distal ends of the damaged common peroneal nerve were sutured to an adjacent normal tibial nerve. Moreover, the possible role and mechanism of the proposed technique were explained at the physiological and anatomical levels. In this study, a 10 mm common peroneal nerve defect was made in SD rats, and the rats were randomly divided into three groups. In Group I, the distal end of the common peroneal nerve was attached end-to-side to the fenestrated tibial nerve adventitia, and the proximal end was ligated and fixed in the nearby muscle. In Group II, the tibial nerve adventitia was fenestrated and the epineurial end-to-end anastomosis surgery was performed to suture the proximal and distal ends of the common peroneal nerve. Rats in Group III were taken as control and received sham operation. Twelve weeks after the operation, the recovery of the repaired nerve and distal effector functions were examined by the sciatic functional index, electrophysiology, osmic acid staining, the muscle wet weight ratio, and the muscle fiber cross-sectional area.ResultsIt was found that these results in Group II were similar to those in Group III, but better than those in Group I. Through retrograde tracing of neurons and Electrophysiological examination in Group II, the study also found that the proximal common peroneal nerve also could establish a connection with tibialis anterior, even gastrocnemius.DiscussionTherefore, it is inferred that fostering both the proximal and distal ends of defective peripheral nerves on normal peripheral nerves using the end-to-side anastomosis technique is a more effective approach to repairing injured nerves. |
| first_indexed | 2024-04-09T19:16:49Z |
| format | Article |
| id | doaj.art-6c68cbb05bcf4580967daaeb6e0a3aba |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T19:16:49Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-6c68cbb05bcf4580967daaeb6e0a3aba2023-04-06T04:47:55ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.10889831088983Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nervesDongdong Li0Qi Yang1Xin Liu2Jing Jia3Guangbo Liu4Kewen Bai5Shicheng Jia6Jun Peng7Fei Yu8Fei Yu9Department of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Ultrasonography, Peking University Shenzhen Hospital, Shenzhen, ChinaDepartment of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen, ChinaDepartment of Orthopedics, Strategic Support Force Medical Center, Beijing, ChinaDepartment of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, ChinaNational and Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, ChinaIntroductionPeripheral nerve defect is a difficult disease to treat in clinical practice. End-to-side anastomosis is a useful method to treat it. At present, the end-to-side anastomosis method does not involve the proximal nerve, which results in a waste of proximal donor nerves, and even the formation of traumatic neuromas at the proximal end. The patients suffer from traumatic neuralgia and the curative effect is unsatisfactory.MethodsIn this study, an improved end-to-side anastomosis technique was proposed in this study: both the proximal and distal ends of the damaged common peroneal nerve were sutured to an adjacent normal tibial nerve. Moreover, the possible role and mechanism of the proposed technique were explained at the physiological and anatomical levels. In this study, a 10 mm common peroneal nerve defect was made in SD rats, and the rats were randomly divided into three groups. In Group I, the distal end of the common peroneal nerve was attached end-to-side to the fenestrated tibial nerve adventitia, and the proximal end was ligated and fixed in the nearby muscle. In Group II, the tibial nerve adventitia was fenestrated and the epineurial end-to-end anastomosis surgery was performed to suture the proximal and distal ends of the common peroneal nerve. Rats in Group III were taken as control and received sham operation. Twelve weeks after the operation, the recovery of the repaired nerve and distal effector functions were examined by the sciatic functional index, electrophysiology, osmic acid staining, the muscle wet weight ratio, and the muscle fiber cross-sectional area.ResultsIt was found that these results in Group II were similar to those in Group III, but better than those in Group I. Through retrograde tracing of neurons and Electrophysiological examination in Group II, the study also found that the proximal common peroneal nerve also could establish a connection with tibialis anterior, even gastrocnemius.DiscussionTherefore, it is inferred that fostering both the proximal and distal ends of defective peripheral nerves on normal peripheral nerves using the end-to-side anastomosis technique is a more effective approach to repairing injured nerves.https://www.frontiersin.org/articles/10.3389/fneur.2023.1088983/fullperipheral nerve defectend-to-side anastomosisfunctional recoveryeffective approachrepair mechanism |
| spellingShingle | Dongdong Li Qi Yang Xin Liu Jing Jia Guangbo Liu Kewen Bai Shicheng Jia Jun Peng Fei Yu Fei Yu Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves Frontiers in Neurology peripheral nerve defect end-to-side anastomosis functional recovery effective approach repair mechanism |
| title | Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| title_full | Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| title_fullStr | Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| title_full_unstemmed | Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| title_short | Experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| title_sort | experimental study on the repair of peripheral nerve injuries via simultaneously coapting the proximal and distal ends of peripheral nerves to the side of nearby intact nerves |
| topic | peripheral nerve defect end-to-side anastomosis functional recovery effective approach repair mechanism |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1088983/full |
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