This experimental work on the internal popliteal nerve of the rabbit was undertaken to clarify whether interposition of a block of 4 mm of fibrin-sealant would form a barrier which stops or interferes with the passage of the axons. Twenty-four adult rabbit tibial nerves were placed in a microclamp, sectioned, and separated 4 mm. The gap between the two nerve ends was filled with fibrin sealant. Eight weeks after the procedure, the animals were sacrificed and the nerves removed. Histologic studies and morphometric longitudinal and transverse examination by image analysis showed that interposition of the block of fibrin sealant between the nerve ends was not a barrier or obstacle to the passage of axons. The use of fibrin sealant is a relatively good experimental model for a chamber of regeneration, because 70 percent of axonal regeneration was obtained.

Function of the wrist and hand in lower root avulsions is severely impaired. Based on anatomic and experimental studies which suggest that the motor nerve of the brachialis muscle could be used as a selective neurotizator in lower root avulsions with intact C5-C6 +/- C7 roots (Klumpke paralysis), we considered its use depending on the target. We describe two techniques for the median nerve (in C8-T1 avulsions) and one for the radial nerve (in C7-C8-T1 avulsions). In all cases, we added the lateral cutaneous nerve of the forearm in the neurotization to improve sensibility in the hand. The present report presents the results of its use in our first five patients.

In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow. Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results 2 - 5. The customary technique as described by various authors is carried out by means of a large submammary incision to harvest three or four intercostal nerves (Figure 1). Then are connected by direct suture or grafts to the musculocutaneous nerve or its motor branches 6 - 7. In this article the authors described the possibility of dissection intercostal nerves by means of assisted video thoracoscopy. (VATS-videdo assisted thoracic surgery).

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