Strain, stress and stretch of peripheral nerve. Rabbit experiments in vitro and in vivo.

Mechanical stretching is known to cause morphologic and functional changes in peripheral nerve. The points at which these changes occur, however, are not clearly defined and reported data are conflicting. The studies presented in this paper provide a basic understanding of the biomechanical properties, stretch-injury patterns, and changes of conduction properties of peripheral nerves due to stretching. Our studies showed that peripheral nerves exhibited non-linear stress-strain characteristics when placed under tension. Initially, under tension, the nerve had a low modulus that increased gradually with increasing strain until reaching a maximal value. When the nerve failed under tension, the perineurium inside the nerve ruptured, but the exterior of the nerve remained intact. Our results also show that a peripheral nerve in situ was under significant strain, but minimal in situ stress (less than 0.05 MPa). The in situ strain might vary with limb position, but did not appear to exceed the limit beyond which substantial tension or stress would be developed in the nerve. The time-dependent viscoelastic behavior of peripheral nerves were also characterized. The maintenance of small in situ stresses suggests that sustained increases in tension could be adversely affecting the electrophysiologic properties of the nerve. Indeed, marked alteration of conduction properties resulted from even a small stretch of 6 percent beyond the in situ length of the nerve, or stress less than 10 percent of the ultimate strength of the nerve.