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《Chinese Journal of Hand Surgery》 2003-04
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Comparative study between end-to-side neurorrhaphy and nerve transposition for repair of brachial plexus injury

LI Wen-jun , PEI Lian-kui , LIANG Bing-sheng, et al. Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China  
Objective To provide the experimental basis for clinical application of end-to-side neurorrhaphy and nerve transposition for repair of brachial plexus injuries. Methods Thirty-six adult Wistar rats were randomly divided into 3 groups: 1 month group, 2 months group and 3 months group, with 12 in each. According to the surgical methods, they were subdivided into 2 groups. In end-to-side neurorrhaphy group( forelimb at the right side) , epineurial window was done at the lateral part of the distal medial cord, the radial nerve at the distal part was sutured to the epineurial window. In nerve transposition group( forelimb at the left side), the median nerve distal to the origin was transected, the proximal of which was sutured with the radial nerve at the distal part. Oectromyographic examination, wet muscle weight, myofibers cross-sectional area, motor-end-plate area, antineurofilament(NF) immunohistochemical analysis and electron microscopy were performed in each group postoperatively. Results The motor nerve conduction velocity, latency of evoked potential and NF positive expression intensity in the end-to-side group were inferior to that in nerve transposition group. There was no significant difference in wet muscle weight, myofibers cross-sectional area and motor-end-plate area between 2 groups. Conclusion Our findings indicate that the distal nerve can be regenerated after end-to-side neurorrhaphy, however, the outcome was remarkably inferior to that of end-to-end neurorrhaphy. Further studies are needed for the clinical application of repair of brachial plexus injuries.
【CateGory Index】: R651
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