J Reconstr Microsurg 2005; 21(1): 43-48
DOI: 10.1055/s-2005-862780
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Reverse End-to-Side Neurotization

Jonathan Isaacs1 , Diane Allen2 , Long En Chen2 , James Nunley2  II 
  • 1Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, VA
  • 2Department of Surgery, Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
Further Information

Publication History

Publication Date:
26 January 2005 (online)

ABSTRACT

The authors describe a reverse end-to-side neurorrhaphy model in which the proximal end of a donor nerve is sutured to an epineurial window in the side of a recipient nerve. If effective, this technique would have useful applications in nerve reconstructive surgery. Female Sprague-Dawley rats were divided into three groups (n = 9). In Group A, the peroneal nerve was transected and directly repaired in standard end-to-end fashion. In Group B, the tibial nerve was transected and the proximal end was sutured to the side of the intact peroneal nerve through an epineurial window. In Group C, the tibial nerve was also transected and the proximal end sutured to the side of the intact peroneal nerve, but the peroneal nerve was then cut proximally. After 12 weeks, contractile forces of the extensor digitorum communis (EDC) were measured, following stimulation of the proximal sciatic nerve on all experimental (and normal) hind limbs. For Group B, the peroneal nerve was transected proximal to the repair site just prior to stimulation. Group B animals did not demonstrate any measurable contractions. No statistically significant differences were found between Groups A and C. This demonstrated the successful neurotization of a denervated muscle using a reverse end-to-side neurorrhaphy model.

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Jonathan IsaacsM.D. 

Department of Orthopedic Surgery, Virginia Commonwealth University

1200 E. Broad Street, P.O. Box 980153

Richmond, VA 23298-0153

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