Aim of the Study: The classic method used to repair nerve injuries is to place the nerve autograft in the nerve gap maintaining the same direction it had in the harvest area. As the axon flow within the nerve cell follows a set direction, this study aims to show the extent and quality of nerve regeneration in grafts where the tissue gap was bridged using an autograft which underwent a 180 degree rotation in respect to its original position at the donor site. Material and Method: As we believe that the inverted direction facilitates regeneration, we placed the graft in the nerve gap rotating it 180 degrees in two different cases: 1) isolated, chronic traumatic injury of the anterior interosseous nerve of the forearm; 2) chronic injury of the median nerve of the forearm. Following the results obtained in man, we drew up an experimental protocol for the rabbit model in order to evaluate the quality and speed of nerve regeneration both in classic and inverted grafts by means of instrumental testing (electromyography - intraoperative electroneurography) and histological sampling. The study was performed on a New Zealand male rabbit and lasted one year. Results: The method we proposed had already lead to outstanding results in man consisting in complete and rapid nerve regeneration and reinnervation in sensory territories previously presenting defects. Our animal model confirmed our hypothesis and the instrumental and histological results further confirmed the value of the procedure. Conclusions: Nerve repair using inverted grafts is, in our opinion, the technique to be used for chronic nerve injuries with a loss of substance. Further investigation is needed to uncover the biochemical, electrical and biological mechanisms involved in this phenomenon. Important hypotheses are presented in this paper.
La rigenerazione nervosa negli innesti a polarità invertita: dati a confronto tra applicazione sull'uomo e analisi sperimentale su modello animale
Burchielli S;
2007
Abstract
Aim of the Study: The classic method used to repair nerve injuries is to place the nerve autograft in the nerve gap maintaining the same direction it had in the harvest area. As the axon flow within the nerve cell follows a set direction, this study aims to show the extent and quality of nerve regeneration in grafts where the tissue gap was bridged using an autograft which underwent a 180 degree rotation in respect to its original position at the donor site. Material and Method: As we believe that the inverted direction facilitates regeneration, we placed the graft in the nerve gap rotating it 180 degrees in two different cases: 1) isolated, chronic traumatic injury of the anterior interosseous nerve of the forearm; 2) chronic injury of the median nerve of the forearm. Following the results obtained in man, we drew up an experimental protocol for the rabbit model in order to evaluate the quality and speed of nerve regeneration both in classic and inverted grafts by means of instrumental testing (electromyography - intraoperative electroneurography) and histological sampling. The study was performed on a New Zealand male rabbit and lasted one year. Results: The method we proposed had already lead to outstanding results in man consisting in complete and rapid nerve regeneration and reinnervation in sensory territories previously presenting defects. Our animal model confirmed our hypothesis and the instrumental and histological results further confirmed the value of the procedure. Conclusions: Nerve repair using inverted grafts is, in our opinion, the technique to be used for chronic nerve injuries with a loss of substance. Further investigation is needed to uncover the biochemical, electrical and biological mechanisms involved in this phenomenon. Important hypotheses are presented in this paper.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
