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Superficial or deep implantation of motor nerve after denervation: an experimental study--superficial or deep implantation of motor nerve.
Microsurgery. 2002; 22(6):242-8.M

Abstract

Neurorraphy, conventional nerve grafting technique, and artificial nerve conduits are not enough for repair in severe injuries of peripheral nerves, especially when there is separation of motor nerve from muscle tissue. In these nerve injuries, reinnervation is indicated for neurotization. The distal end of a peripheral nerve is divided into fascicles and implanted into the aneural zone of target muscle tissue. It is not known how deeply fascicles should be implanted into muscle tissue. A comparative study of superficial and deep implantation of separated motor nerve into muscle tissue is presented in the gastrocnemius muscle of rabbits. In this experimental study, 30 white New Zealand rabbits were used and divided into 3 groups of 10 rabbits each. In the first group (controls, group I), only surgical exposure of the gastrocnemius muscle and motor nerve (tibial nerve) was done without any injury to nerves. In the superficial implantation group (group II), tibial nerves were separated and divided into their own fascicles. These fascicles were implanted superficially into the lateral head of gastrocnemius muscle-aneural zone. In the deep implantation group (group III), the tibial nerves were separated and divided into their own fascicles. These fascicles were implanted around the center of the muscle mass, into the lateral head of the gastrocnemius muscle-aneural zone. Six months later, histopathological changes and functional recovery of the gastrocnemius muscle were investigated. Both experimental groups had less muscular weight than in the control group. It was found that functional recovery was achieved in both experimental groups, and was better in the superficial implantation group than the deep implantation group. EMG recordings revealed that polyphasic and late potentials were frequently seen in both experimental groups. Degeneration and regeneration of myofibrils were observed in both experimental groups. New motor end-plates were formed in a scattered manner in both experimental groups. However, they were more dense in the superficial implantation group than the deep implantation group. It was concluded that superficial implantation has a more powerful contractile capacity than that of deep implantation. We believe that this might arise from the high activity of glycolytic enzymes in peripheral muscle fibers of gastrocnemius muscle, decrease in insufficient intramuscular guidance apparatus, and intramuscular microneuroma formation at the insufficient neuromuscular junction since the motor nerve had less route to muscle fibers.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Dicle University Medical School, Diyarbakir, Turkey. iaskar@superonline.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12375290

Citation

Askar, Ibrahím, and Bízden Tavíl Sabuncuoglu. "Superficial or Deep Implantation of Motor Nerve After Denervation: an Experimental Study--superficial or Deep Implantation of Motor Nerve." Microsurgery, vol. 22, no. 6, 2002, pp. 242-8.
Askar I, Sabuncuoglu BT. Superficial or deep implantation of motor nerve after denervation: an experimental study--superficial or deep implantation of motor nerve. Microsurgery. 2002;22(6):242-8.
Askar, I., & Sabuncuoglu, B. T. (2002). Superficial or deep implantation of motor nerve after denervation: an experimental study--superficial or deep implantation of motor nerve. Microsurgery, 22(6), 242-8.
Askar I, Sabuncuoglu BT. Superficial or Deep Implantation of Motor Nerve After Denervation: an Experimental Study--superficial or Deep Implantation of Motor Nerve. Microsurgery. 2002;22(6):242-8. PubMed PMID: 12375290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Superficial or deep implantation of motor nerve after denervation: an experimental study--superficial or deep implantation of motor nerve. AU - Askar,Ibrahím, AU - Sabuncuoglu,Bízden Tavíl, PY - 2002/10/11/pubmed PY - 2003/1/15/medline PY - 2002/10/11/entrez SP - 242 EP - 8 JF - Microsurgery JO - Microsurgery VL - 22 IS - 6 N2 - Neurorraphy, conventional nerve grafting technique, and artificial nerve conduits are not enough for repair in severe injuries of peripheral nerves, especially when there is separation of motor nerve from muscle tissue. In these nerve injuries, reinnervation is indicated for neurotization. The distal end of a peripheral nerve is divided into fascicles and implanted into the aneural zone of target muscle tissue. It is not known how deeply fascicles should be implanted into muscle tissue. A comparative study of superficial and deep implantation of separated motor nerve into muscle tissue is presented in the gastrocnemius muscle of rabbits. In this experimental study, 30 white New Zealand rabbits were used and divided into 3 groups of 10 rabbits each. In the first group (controls, group I), only surgical exposure of the gastrocnemius muscle and motor nerve (tibial nerve) was done without any injury to nerves. In the superficial implantation group (group II), tibial nerves were separated and divided into their own fascicles. These fascicles were implanted superficially into the lateral head of gastrocnemius muscle-aneural zone. In the deep implantation group (group III), the tibial nerves were separated and divided into their own fascicles. These fascicles were implanted around the center of the muscle mass, into the lateral head of the gastrocnemius muscle-aneural zone. Six months later, histopathological changes and functional recovery of the gastrocnemius muscle were investigated. Both experimental groups had less muscular weight than in the control group. It was found that functional recovery was achieved in both experimental groups, and was better in the superficial implantation group than the deep implantation group. EMG recordings revealed that polyphasic and late potentials were frequently seen in both experimental groups. Degeneration and regeneration of myofibrils were observed in both experimental groups. New motor end-plates were formed in a scattered manner in both experimental groups. However, they were more dense in the superficial implantation group than the deep implantation group. It was concluded that superficial implantation has a more powerful contractile capacity than that of deep implantation. We believe that this might arise from the high activity of glycolytic enzymes in peripheral muscle fibers of gastrocnemius muscle, decrease in insufficient intramuscular guidance apparatus, and intramuscular microneuroma formation at the insufficient neuromuscular junction since the motor nerve had less route to muscle fibers. SN - 0738-1085 UR - https://www.unboundmedicine.com/medline/citation/12375290/Superficial_or_deep_implantation_of_motor_nerve_after_denervation:_an_experimental_study__superficial_or_deep_implantation_of_motor_nerve_ L2 - https://doi.org/10.1002/micr.10044 DB - PRIME DP - Unbound Medicine ER -