Limits...
Clinical applications of end-to-side neurorrhaphy: an update.

Tos P, Colzani G, Ciclamini D, Titolo P, Pugliese P, Artiaco S - Biomed Res Int (2014)

Bottom Line: End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible.In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results.In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Traumatology and Rehabilitation, Microsurgery Unit, AO Città della Salute e della Scienza, Orthopaedic and Trauma Center, Via Zuretti 29, 10126 Turin, Italy.

ABSTRACT
End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible. In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results. In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.

Show MeSH

Related in: MedlinePlus

Median nerve section with extensive loss of substance at the forearm.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4127263&req=5

fig1: Median nerve section with extensive loss of substance at the forearm.

Mentions: Treatment of mixed nerves defects can be easily performed by end-to-side coaptation, particularly between median and ulnar nerves at the forearm (Figures 1 and 2). Mennen reported thirty-three cases of ulnar to median nerve suture and seven of median to ulnar nerve suture, with satisfying sensory recovery despite poor motor recovery [16]. This conformed previous findings by Luo et al. [30]. Improvement in protective sensibility was also demonstrated by some authors performing median to ulnar end-to-side coaptation in several cases reported in the literature with long nerve defects [31–34]. In such cases only partial motor recovery was occasionally seen. Probably the cause has to be found in the difficulty of regenerating axons to match properly sensory and motor fibers in mixed nerve [31, 33]. In these situations a neurotization seems to be a more reliable surgical option.


Clinical applications of end-to-side neurorrhaphy: an update.

Tos P, Colzani G, Ciclamini D, Titolo P, Pugliese P, Artiaco S - Biomed Res Int (2014)

Median nerve section with extensive loss of substance at the forearm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127263&req=5

fig1: Median nerve section with extensive loss of substance at the forearm.
Mentions: Treatment of mixed nerves defects can be easily performed by end-to-side coaptation, particularly between median and ulnar nerves at the forearm (Figures 1 and 2). Mennen reported thirty-three cases of ulnar to median nerve suture and seven of median to ulnar nerve suture, with satisfying sensory recovery despite poor motor recovery [16]. This conformed previous findings by Luo et al. [30]. Improvement in protective sensibility was also demonstrated by some authors performing median to ulnar end-to-side coaptation in several cases reported in the literature with long nerve defects [31–34]. In such cases only partial motor recovery was occasionally seen. Probably the cause has to be found in the difficulty of regenerating axons to match properly sensory and motor fibers in mixed nerve [31, 33]. In these situations a neurotization seems to be a more reliable surgical option.

Bottom Line: End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible.In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results.In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Traumatology and Rehabilitation, Microsurgery Unit, AO Città della Salute e della Scienza, Orthopaedic and Trauma Center, Via Zuretti 29, 10126 Turin, Italy.

ABSTRACT
End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible. In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results. In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.

Show MeSH
Related in: MedlinePlus