Comparative study for the nerve repair of mismatched nerves and nerve regeneration

Objective To investgate the relationship between nerve repair of mismatched nerves and nerve regeneration. Methods The six different neurorrhaphies, trunk to trunk suture, trunk to fasciculus suture, embedded suture, end to side suture, non and little gap sleeve insertion through vein conduit, were used to transfer the phrenic nerve to the lateral cord in the rat model of brachial plexus root avulsion. Electrophysiological, histological examinations and functional evaluation were used to assess nerve regeneration and the functional recovery of the biceps brachii muscle postoperatively. Results At the fourth month after operaton, the end to end coaptation groups were superior to the end to side group in all parameters. Among the end to end coaptation groups, except that the delayed rates of latency and the maximal persistent time had no statistically significant differences, the myelinated axon conduits of the two vein conduit sleeve insertion groups were superior to that of trunk to fasci culus group. The other parameters indicated that the the vein conduit sleeve insertion groups, embedded group and trunk to trunk group had no significant statistical difference, but they were superior to the trunk to fasci group. Conclusion 1. The end to end coaptation is superior to the end to side coaptation. 2. The trunk to trunk coaptation is superior to the trunk to fasciculus coaptation. 3. The sleeve insertion is superior to direct suture. 4. The statisficul difference of non and little gap vein conduit sleeve insertion groups are not statistically significant(Shanghai Med J, 1999,22:143 146).