End‐to‐side nerve grafting of the tibial nerve to bridge a neuroma‐in‐continuity

Kerns, James M.; Sladek, Eduard H.; Malushte, Tejashree S.; Bach, H. Gregory; Elhassan, Bassem T.; Kitidumrongsook, Pravit; Shott, Susan; Gantsoudes, George; Gonzalez, Mark H.

doi:10.1002/micr.20321

Cited by 8 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, this study proposes a new technique for complete loop neurorrhaphy, and with maximum surface contact of the injured distal stump in relation to the healthy nerve, followed by end-to-side suture. The surgical technique of loop neurorrhaphy is justified for using intact nerve (which "stabilizes" the suture when reducing the local tension (Amr et al; Xiong et al) by reducing the intraluminal pressure and allowing neovascularization, axoplasmic flow, cell migration and advance of the axonal growth cone (Kerns et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

End-To-Side Loop Neurorrhaphy: Axonal Comparative Stereological Study

et al. 2014

View full text Add to dashboard Cite

VITERBO, F.; FALEIROS, H. R.; BATIGALIA, F.; BOER, A. L. R.; CARVALHO Jr., A. A. End-to-side loop Neurorrhaphy: axonal comparative stereological study. Int. J. Morphol., 32(3):942-949, 2014.SUMMARY: Accidents or diseases can affect the peripheral part of the nervous system, which raises clinical and surgical therapies, among others. In this context, the technique of end-to-side neurorrhaphy is a treatment option, yet its modification loop needs some additional efficacy studies. The purpose of this study was to compare, among rats, stereological results (axons volume density) after end-to-side neurorrhaphy and after end-to-side loop neurorrhaphy. Thirty Wistar rats were used, divided into six groups (five animals per group), consisting of two control groups (for the fibular and tibial nerves), two study groups for the fibular nerve (one with an end-to-side neurorrhaphy, and the other with an end-to-side loop neurorrhaphy) and two study groups for the tibial nerve (with an endto-side neurorrhaphy and the other one with an end-to-side loop neurorrhaphy). After 180 days, all groups were sacrificed for axonal stereological analysis (volume density) in distal nerve stumps. There was significant maintenance of neuronal-axonal density in the distal stumps to neurorrhaphy (p<0.005) compared with the normal stumps. The end-to-side loop neurorrhaphy is a therapeutic option as suture technique after complete nerve section, in order to restore most of the axonal functional integrity.

show abstract

Section: Discussionmentioning

confidence: 99%

End-To-Side Loop Neurorrhaphy: Axonal Comparative Stereological Study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Nessas situações, os trabalhos experimentais demonstram que, mesmo naqueles ditos eletricamente "silenciosos", alguns axônios conseguem ultrapassar a lesão. O seu tratamento-padrão inclui testes eletrofisiológicos (NAPs) transoperatórios, e, caso estes sejam negativos, procede-se à ressecção da lesão e à reconstrução do nervo por meio do uso de enxertos 10 . Portanto, utilizando a técnica convencional, o cirurgião sacrificaria esses poucos axônios que foram capazes de ultrapassar o neuroma.…”

Section: Figura 2 -Uso Da Técnica De Sutura Término-lateral Para Tratunclassified

“…A sutura término-terminal sempre permaneceu como o princípio básico da técnica de reconstrução de nervos periféricos. Objetiva o melhor alinhamento possível dos condutos axonais, seja por meio de sutura direta dos cotos do nervo lesado, seja por meio da interposição de enxertos entre eles 10 . Porém essa técnica mostrou limitações em determina-das situações, como nos casos em que o acesso a um desses cotos é impossível, ou quando a distância entre eles é grande (o que, em geral, leva a maus resultados operatórios).…”

Section: Introdução E Evolução Históricaunclassified

Neurorrafia término-lateral Uma evolução da técnica de reparo de lesões de nervos periféricos?

Flores¹

2006

Arq Bras Neurocir

View full text Add to dashboard Cite

show abstract

“…Reverse end-to-side neurotization [16] allowed neurotization of partially injured recipient nerves without downgrading already regained recipient muscle power, a technique which we called nerve augmentation. This was tried out experimentally [17]. It was also carried out in early complete obstetric brachial plexus palsy [18].…”

Section: Introductionmentioning

confidence: 99%

Augmentation of partially regenerated nerves by end-to-side side-to-side grafting neurotization: experience based on eight late obstetric brachial plexus cases

Amr

Moharram

Abdel-Meguid

2014

J Brachial Plex Peripher Nerve Inj

View full text Add to dashboard Cite

ObjectiveThe effect of end-to-side neurotization of partially regenerated recipient nerves on improving motor power in late obstetric brachial plexus lesions, so-called nerve augmentation, was investigated.MethodsEight cases aged 3 – 7 years were operated upon and followed up for 4 years (C5,6 rupture C7,8T1 avulsion: 5; C5,6,7,8 rupture T1 avulsion:1; C5,6,8T1 rupture C7 avulsion:1; C5,6,7 ruptureC8 T1 compression: one 3 year presentation after former neurotization at 3 months). Grade 1–3 muscles were neurotized. Grade0 muscles were neurotized, if the electromyogram showed scattered motor unit action potentials on voluntary contraction without interference pattern. Donor nerves included: the phrenic, accessory, descending and ascending loops of the ansa cervicalis, 3rd and 4th intercostals and contralateral C7.ResultsSuperior proximal to distal regeneration was observed firstly. Differential regeneration of muscles supplied by the same nerve was observed secondly (superior supraspinatus to infraspinatus regeneration). Differential regeneration of antagonistic muscles was observed thirdly (superior biceps to triceps and pronator teres to supinator recovery). Differential regeneration of fibres within the same muscle was observed fourthly (superior anterior and middle to posterior deltoid regeneration). Differential regeneration of muscles having different preoperative motor powers was noted fifthly; improvement to Grade 3 or more occurred more in Grade2 than in Grade0 or Grade1 muscles. Improvements of cocontractions and of shoulder, forearm and wrist deformities were noted sixthly. The shoulder, elbow and hand scores improved in 4 cases.LimitationsThe sample size is small. Controls are necessary to rule out any natural improvement of the lesion. There is intra- and interobserver variability in testing muscle power and cocontractions.ConclusionNerve augmentation improves cocontractions and muscle power in the biceps, pectoral muscles, supraspinatus, anterior and lateral deltoids, triceps and in Grade2 or more forearm muscles. As it is less expected to improve infraspinatus power, it should be associated with a humeral derotation osteotomy and tendon transfer. Function to non improving Grade 0 or 1 forearm muscles should be restored by muscle transplantation.Level of evidenceLevel IV, prospective case series.

show abstract

End‐to‐side nerve grafting of the tibial nerve to bridge a neuroma‐in‐continuity

Cited by 8 publications

References 0 publications

End-To-Side Loop Neurorrhaphy: Axonal Comparative Stereological Study

End-To-Side Loop Neurorrhaphy: Axonal Comparative Stereological Study

Neurorrafia término-lateral Uma evolução da técnica de reparo de lesões de nervos periféricos?

Augmentation of partially regenerated nerves by end-to-side side-to-side grafting neurotization: experience based on eight late obstetric brachial plexus cases

Contact Info

Product

Resources

About