End-to-side neurorrhaphy has gained popularity for the treatment of select peripheral nerve injuries such as when the proximal nerve stump is not available or far removed from the target muscle. In end-to-side neurorrhaphy the distal end of an injured nerve is sutured to the lateral aspect of an intact nerve. However, it remains unclear whether intentional injury (transection) of the donor nerve is necessary to enhance motor recovery. In this report, the authors address this question by studying three end-to-side repair techniques corresponding to progressively greater donor nerve injury in a rodent model.
The results suggest that there is a dose-response relationship between progressive nerve injury and motor neuron regeneration. Thus the authors conclude that deliberate donor nerve axotomy is necessary to optimize motor neuronal regeneration with the end-to side neurorrhaphy. At present, the utility and application of this technique in a clinical setting remains somewhat unclear. This study is another step in identifying the appropriate indication and optimal surgical techniques required for its use.
Nerve, Regeneration, Neurrorrhaphy, End, Side, Repair
Plastic and Reconstr Surg