Changes in nerve fiber numbers distal to a nerve repair in the sciatic nerve of 48 rats were evaluated over a 1- to 24-month period. The results of the morphometric evaluation in the sciatic nerve distal to the nerve repair demonstrated an increase in nerve fiber counts as early as 1 month following the nerve repair. The number of nerve fibers in the distal nerve was greatest at 3 months and did not return to normal levels until 24 months. The results of this study will influence the timing of experimental studies in which nerve fiber counts are critical for evaluation, and provides a better understanding of the clinical events occurring following nerve repair.
The differential diagnosis of groin pain must consider problems of the ilioinguinal and/or genitofemoral nerve. These nerves may become injured during hernia surgery or lower quadrant surgical procedures. To treat injury to these nerves, it is critical to understand their anatomic variability. In the present study the pattern of cutaneous nerve branches in the inguinal region was investigated through dissection in 64 halves of 32 human embalmed anatomic specimens. In contrast to usual textual descriptions, four different types of cutaneous branching patterns are identified: type A, with a dominance of genitofemoral nerve in the scrotal/labial and the ventromedial thigh region. In type A, the ilioinguinal nerve gives no sensory contribution to these regions (43.7 percent). In type B, with a dominance of ilioinguinal nerve, the genitofemoral nerve shares a branch with the ilioinguinal and gives motor fibers to cremaster muscle in the inguinal canal, but has no sensory branch to the groin (28.1 percent). In type C, with a dominance of genitofemoral nerve, the ilioinguinal nerve has sensory branches to the mons pubis and inguinal crease together with an anteroproximal part of the root of the penis or labia majora. The nerve was found to share a branch with the iliohypogastric nerve (20.3 percent). In type D, cutaneous branches emerge from both the ilioinguinal and the genitofemoral nerves. Additionally, the ilioinguinal nerve innervates the mons pubis and inguinal crease together with a very anteroproximal part of the root of the penis or labia majora (7.8 percent). The described patterns of innervation were bilaterally symmetric in 40.6 percent of the cadavers. The anatomic variability of both nerves has implications for all surgeons operating in the groin region and for those caring for the patient with groin pain.
Anatomical variations in the musculofascial structures about the region of the medial humeral epicondyle were evaluated in 104 extremities in sixty-four cadavers. This study demonstrated presence of an Osborne's band in 77%, of some degree of ulnar subluxation in 25%, of an epitrochlearis anconeus muscle in 11%, the ulnar nerve beneath the medial head of the triceps in 24%, the medial head of the triceps within the floor of the cubital tunnel in 28%, the presence of a rudimentary supracondylar process in 1.5%, and a high origin of the pronator teres in 17% of the cadavers. There was a significant association between the presence of an epitrochlearis anconeus muscle and the ulnar nerve being completely covered by the medial head of the triceps muscle (p less than .001). There was a significant relationship between the presence of the medial head of the triceps in the cubital tunnel and ulnar nerve subluxation (p.001). The high origin of the pronator teres may provide a proximal site for "double crush" syndromes of the median nerve.
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