Effects of Time Lapse on Results of Partial Nerve Injury Repair

ABSTRACT

Partial nerve severance is a problem in peripheral-nerve surgery. It should be repaired without tension for a good functional result. There is usually no trouble in repairing acute injuries. But, as time passes, it may be difficult to establish a proper end-to-end repair, and this cause more tension at the repair sites. In this study, the critical time lapse for a deleterious effect was evaluated. Thirty rats were used, with partial nerve severance repaired immediately or at 10 or 20 days later. At 2, 4, 8, 12, 20, and 28 weeks, functional assessment of nerve regeneration was performed using walking-track analysis. Functionally, the sciatic index values were very close to each other in the immediate and 10-day-delay group, but the difference between these groups and the 20-day-delay group was statistically significant. The study suggests a critical period of about 2 weeks after partial nerve section before irreversible changes occur. Although this is not applicable to human models, it implies further work on a primate model for determining a reliable time-lapse period.

KEYWORDS

Partial nerve injury - time lapse - nerve repair

REFERENCES

• 1 Lundborg G. Nerve Injury and Repair. New York; Churchill Livingstone 1988
• 2 Millesi H. Reappraisal of nerve repair.  Surg Clin North Am. 1981;  61 321-326
• 3 Bain J R, Mckinnon S E, Hunter R T. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat.  Plast Reconstr Surg. 1989;  83 129-134
• 4 Dellon E S, Dellon A L. Functional assessment on neurologic impairment: track analysis in diabetic and compression neuropathies.  Plast Reconstr Surg. 1991;  88 251-257
• 5 Harris M E, Tindall S C. Techniques of peripheral nerve repair.  Neurosurg Clini N America. 1991;  2 93-98
• 6 Terzis J K, Smith K L. Repair and grafting of the peripheral nerve. In: McCarthy JG, May JW, Littler JW Plastic Surgery. Philadelphia; W.B. Saunders Company 1990
• 7 Millesi H. Treatment of nerve lesions by fascicular free nerve grafts. In: Micho J, Moberg E Traumatic Nerve Lesions Edinburgh; Churchill Livingstone 1975
• 8 Millesi H. Peripheral nerve repair: terminology, questions and facts.  J Reconstr Surg. 1985;  2 21-28
• 9 Kline D G, Hackett E R. Value of electrophysiologic tests for peripheral nerve neuromas.  J Surg Oncol. 1970;  2 299-304
• 10 Kallio P K, Vastamaki M. An analysis of the results of late reconstructions of 132 median nerves.  J Hand Surg. 1993;  18B 97-102