Functional and Morphological Study on the Contribution from Proximal Nerve Stump in Double End-to-side Nerve Repair of Median Nerve in the Rat - Comparison with Classical End-to-side Nerve Repair -

Journal of the Korean Society for Surgery of the Hand 2007;12(1):1-10.
Published online March 1, 2007.

Jun Mo Jung, Goo Hyun Baek, Young Ho Lee, Hyun Sik Gong, Young Jae Cho, Jong Hyun Park, Moon Sang Chung

백서 정중신경의 이중 단측 문합 모델의 신경 재생에서 신경 근위단의 기여도에 대한 기능적 및 형태학적 연구 - 이중 단측 문합과 고전적 단측 문합과의 비교 -

정준모, 백구현, 이영호, 공현식, 조영재, 박종현, 정문상

Abstract

The aim of this study is to evaluate the effect of the contribution from the proximal nerve stump in end-toside nerve repair on functional recovery, by modifying the classic end-to-side neurorrhaphy and suturing the proximal nerve stump to a donor nerve in a rat model with severed median nerve. Three experimental groups (n=15) were used: modified end-to-side neurorrhaphy with suturing the proximal nerve stump (double end-to-side neurorrhaphy) (Group I), a classic end-to-side neurorrhaphy (Group II), and a control group without neurorrhaphy (Group III). Grasping tests were undergone before surgery and 10, 20 weeks after surgery. At week 10, both the median and ulnar nerves of the opposite front paw were excised respectively and sampled to gain the normal nerve tissue, disabling the opposite front paw to grasp the grid. After measuring grasping strength at week 20, the sutured wound was re-exposed, and muscle contractility force tests and tissue sampling were undergone. The grasping strength, tetanic force and nerve fiber count of the distal stump were significantly higher in group I than group II and there was no evidence of nerve recovery in group III. Therefore, the contribution from proximal nerve stump in double end-to-side nerve repair could improve axonal sprouting from donor nerve and help to get better functional recovery in end-to-side coaptation model.