Comparison of Peripheral Nerve Regeneration with Side-to-side, End-to-side, and End-to-end Repairs: An Experimental Study. 2016

Henrikki Rönkkö, and Harry Göransson, and Hanna-Stiina Taskinen, and Pasi Paavilainen, and Tero Vahlberg, and Matias Röyttä
Department of Orthopaedics, Hatanpää City Hospital, Tampere, Finland; Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland; Department of Hand Surgery, Turku University Hospital, Turku, Finland; and §Institute of Clinical Medicine, Department of Biostatistics, and Department of Pathology/ Neuropathology, Turku University Hospital, University of Turku, Turku, Finland.

BACKGROUND The present study was conducted to find out a tool to enable improved functional recovery with proximal nerve injury. In this experimental study, nerve regeneration was compared between side-to-side (STS), end-to-side (ETS), and end-to-end repairs. METHODS The walk track analysis was used as an outcome of functional recovery. Nerve regeneration was studied with morphometry and histology 6 or 26 weeks postoperatively. RESULTS All 3 repair techniques showed regeneration of the nerve. From 12 weeks onward, the functional results of the 3 intervention groups were significantly better compared with the unrepaired control group. End-to-end repair was significantly better when compared with the STS and ETS groups. At 26 weeks, the functional and morphometric results and histologic findings did not differ between the STS and ETS groups. The functional results correlated with the morphometric findings in all groups. CONCLUSIONS STS neurorrhaphy showed nerve regeneration, and the end results did not differ from clinically widely used ETS repair. Further studies are warranted to optimize the neurorrhaphy technique and examine possible applications of STS repair in peripheral nerve surgery.

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