Variation in nerve autograft length increases fibre misdirection and decreases pruning effectiveness. An experimental study in the rat median nerve

Bertelli, Jayme Augusto; Taleb, Madjid; Mira, Jean‐Claude; Ghizoni, Marcos Flávio

doi:10.1179/016164105x18494

Cited by 32 publications

(23 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to the axonal misalignments at the proximal and distal coaptation sites, the regenerating axons would grow aberrantly throughout the grafts. 5,6 In those cases, it would be beneficial to employ prosthetic tubulization. We expected that an impermeable conduit placed at the distal end of the nerve graft might correct, at least partly, the axonal misdirection by gradual axon dispersion within the closed space.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of conduit repair on aberrant motor axon growth within the nerve graft in rats

et al. 2007

View full text Add to dashboard Cite

After peripheral nerve injury, minimizing axonal misdirection has been a matter of importance to obtain good functional outcomes. In general, it becomes more challenging as the nerve defect length is longer. As previous works suggested that a conduit repair leaving a short gap could induce some target-specific reinnervation, we expected that a distally placed conduit combined with nerve graft would enhance the specificity of reinnervation, especially in dealing with a long gap. To test this, a 14-mm-long gap was created in the rat sciatic nerves and repaired with either 1) whole nerve graft (WG), 2) interfascicular nerve grafts (FG), or 3) whole nerve graft combined with distally placed silicone tube leaving a 5-mm gap (TUBG). At the end of follow up, the extent of target specific reinnervation (measurement of the compound muscle action potentials evoked by stimulation of the sciatic nerve and its tibial and common peroneal fascicles) and the accuracy of motoneuronal projection (sequential retrograde labeling of the common peroneal motor pool) were assessed. Both assessments revealed that groups FG and TUBG had a similar selectivity, which was significantly higher than in group WG. Consistent with these results, the functional recovery as assessed by walking track analysis showed no significant difference between groups FG and TUBG, whereas those were significantly superior to group WG. In contrast, histomorphometric assessment of the regenerating axons and wet muscle weight showed no significant difference among the three groups. In conclusion, conduit repair would have some effects on reducing motor axonal misdirection, and it might be more effective when used in the management of a large defect in combination with nerve graft.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, such ideal fascicular grafts are rarely available in the clinical setting, thereby resulting in aberrant projections at both proximal and distal coaptation sites. 5 Moreover, as it has been suggested that the regenerating axons become aberrant throughout the nerve graft length, 5,6 the graft length itself would also increase axonal misdirection.…”

mentioning

confidence: 98%

Effect of conduit repair on aberrant motor axon growth within the nerve graft in rats

et al. 2007

View full text Add to dashboard Cite

show abstract

“…The basic mechanism leading to poor recovery appears to be related to increased fiber misdirection and defective pruning in longer grafts. 25 The accessory nerve is pure motor and innervates, distal to the repair site, a single muscle. Fiber misdirection probably exists to a lesser extent, thereby having a smaller effect on recovery; this explains the good results we obtained.…”

Section: Discussionmentioning

confidence: 99%

Refinements in the Technique for Repair of the Accessory Nerve

Bertelli

Ghizoni

2006

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…In general, regeneration through shorter grafts is better. 13 In brachial plexus repairs, however, short grafts are connected to the divisions of the brachial plexus, rather than to the terminal branches. This may decrease the success of reconstruction, because of dispersion of the regenerating nerve fibers, a well-known concept among brachial plexus surgeons.…”

Section: Elbow Motionmentioning

confidence: 99%

Results of Grafting the Anterior and Posterior Divisions of the Upper Trunk in Complete Palsies of the Brachial Plexus

Bertelli

Ghizoni

2008

The Journal of Hand Surgery

View full text Add to dashboard Cite

Variation in nerve autograft length increases fibre misdirection and decreases pruning effectiveness. An experimental study in the rat median nerve

Abstract: Variation in the length of nerve grafts interferes in behavioural recovery and increases motor fibres misdirection. Early recovery onset was related to a better outcome, which occurs in the short graft group.

Cited by 32 publications

References 42 publications

Effect of conduit repair on aberrant motor axon growth within the nerve graft in rats

Effect of conduit repair on aberrant motor axon growth within the nerve graft in rats

Refinements in the Technique for Repair of the Accessory Nerve

Results of Grafting the Anterior and Posterior Divisions of the Upper Trunk in Complete Palsies of the Brachial Plexus

Contact Info

Product

Resources

About