Influences of Repair Site Tension and Conduit Splinting on Peripheral Nerve Reconstruction
| Autor: | Christopher J. Dy, Dana Rioux-Forker, Jason Wever, Fraser J. Leversedge, David M. Brogan |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Isograft Nerve guidance conduit Neurosurgical Procedures Rats Sprague-Dawley 03 medical and health sciences 0302 clinical medicine Electrical conduit medicine Animals Orthopedics and Sports Medicine Axon 030304 developmental biology 030222 orthopedics 0303 health sciences business.industry Tension (physics) Sciatic Nerve Axons Surgery Rats Nerve Regeneration Splints medicine.anatomical_structure Sciatic nerve Splint (medicine) business |
| Zdroj: | Hand (New York, N.Y.). 17(6) |
| ISSN: | 1558-9455 |
| Popis: | Background We investigated the use of a conduit splinting technique to mitigate tension at the coaptation site of a rodent nerve defect model to determine the optimal reconstruction method for segmental nerve defects. Methods A rat sciatic nerve segmental defect model was created by excising 5mm of the sciatic nerve unilaterally. Four groups of 10 rats were each reconstructed using 1 of 4 techniques: primary repair, repair with conduit splinting, reverse isograft with conduit splinting, and reverse isograft without splinting. Functional outcomes were assessed at 6 weeks by measurement of Sciatic Functional Index (SFI), and sciatic nerves were harvested at the nonsurvival surgery. Histomorphologic measurements were reported as a value normalized to the average measurements of the control side. The primary outcomes were assessment of nerve continuity and the proportion of nerve fibers in the regenerating nerve compared with the uninjured side. Results The number of repair site rupture rates was lower when a conduit splint was used—less than half of the primary repairs under tension remained intact at 6 weeks. No difference was seen in axon number, size, and density between primary repairs and those augmented by conduit splints, but worse functional outcomes and more debris were present compared with the intact primary repairs. Conclusions Nerve conduit splinting reduced rupture rates, particularly for nerve repairs associated with a segmental defect. No significant difference was seen in the number of axons among techniques. Primary nerve repair under tension that did not rupture demonstrated superior SFI. |
| Databáze: | OpenAIRE |
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