The aim of the study is to investigate the possibility of reinnervation and prevention of muscle atrophy following side to side neurorrhaphy to the intact nerve after end to end repair of proximal transected peripheral nerves in order to prevent distal target organ atrophy. For this, four groups each containing five SpragueDawley female rats were used. In group I, no surgical procedure was performed as a control group. In group II, side to side distal neurorrhaphy performed to the tibial and peroneal nerves after end to end repair of transected proximal tibial nerve. In group III. distally side to side epineural neurorrhaphy performed to the tibial and peroneal nerves. In group IV, end to end epineural repair was performed after proximal tibial nerve transection. The rats were followed up for 3 months for nerve regeneration. Subsequently group II, III and IV were evaluated histopathologically. In all group, tibial and fibular bony weights, foot weights, anterior and posterior crural muscle weights and EMG parameters were evaluated. Comparison between the groups revealed no significant differences regarding EMG and muscle weights between groups 2 and 4 also axonal degeneration was observed in 3 group after neurorrhaphy. As result of experimental study, we think that side to side repair of intact distal nerves as an adjunct to end to end repair of proximal nerve transections has no additional benefit to prevent distal organ atrophy but rather may be caused harm on the intact nerve. In addition, it has been observed that this technique affects the intact nerve rather than the transected nerve.
Key words: Proximal nerve transection, end to end, side to side, nerve repair
|
