End-to-side neurorrhaphies in a rodent model of peripheral nerve injury: a preliminary report of a novel technique

Abstract

The authors have preliminarily shown that regeneration occurs both electrophysiologically and histologically with a double-TLN jump graft. Clinically, this method could offer an alternative strategy for the technique and timing of neuroma repair.

A systematic review of animal models for experimental neuroma

“…Morphological analysis is the most commonly used method, usually performed in light, 18,22,24,26,27,29,45,46,32,34,50,36,38,43,44,49,19,20,47,39,49 electron, 10,30,32,50,36,40 fluorescence 19,37,38,40 or confocal laser microscopy. 20,43,44 Data on the level where biopsies of the nerve and the neuroma are taken and analysed are heterogeneous and often missing, preventing appropriate comparison of results: Chim et al 16 Haematoxylin and eosin 16,18e20,36,50,37,40,49 and toluidine blue 10,18,22,32,45,46,24,19,25,27,30,38,43,…”

“…28 Some authors also compare different mechanisms of injury in the same animal model. 37,38,40,41,44 Although other types of injuries are well reproducible, crush injuries are difficult to standardise in terms of pressure applied and subsequent response, making comparison of results difficult. Moreover, nerve crush injuries in rats always correspond to Sunderland's grades 2 and 3, and they are likely to undergo spontaneous recovery; thus, crush should not be considered as the method of choice for NIC models.…”

“…10 67 recently reviewed the rat sciatic nerve model, and they supported it as a 'simple and subtle model for investigating many aspects of nervous system damage and recovery'. Other popular models are the tibial, 18,22,40,41 sural, 16 peroneal 39,49 or saphenous nerves. 23,31 The forelimb has been less often used and mostly for terminal neuromas.…”

“…16,31,34,51 Models of NIC are less numerous, and they have received attention only in the last 10 years. They aim at reproducing a Sunderland's grade 3 and 4 nerve injuries 68 through crush injuries, 40 crush and distal transection, 36,39 partial transection, 41 transection and suture 40,43 or partial ligation. 28 Some authors also compare different mechanisms of injury in the same animal model.…”

End-to-Side Nerve Repair in Peripheral Nerve Injury

“…Whether the regenerating sensory axons lead to paresthesia or dysesthesia is not cleared yet (Aszmann et al, 2003). According to a recent paper, the end-to-side "jump grafts" bypass a neuroma in-continuity, maintaining functional units within the nerve lesion to facilitate functional regeneration (Adelson et al, 2004). This method may offer an alternative technique for neuroma repair.…”