Lim Aymeric Y T, Lahiri Amitabha, Pereira Barry P, Tan Jessie A C, Sebastin Sandeep J, Tan Bee-Leng, Zheng Ling, Prem Kumar V
Department of Hand & Reconstructive Microsurgery, National University Hospital, 5 Lower Kent Ridge Road, 119074 Singapore.
Muscle Nerve. 2006 Mar;33(3):377-83. doi: 10.1002/mus.20468.
The repair of lacerated muscle often results in suboptimal recovery. An important cause of poor outcome is denervation of the distal segment. The rabbit medial gastrocnemius muscle laceration model was used to assess whether intramuscular nerve repair resulted in better recovery. Lacerated rabbit muscles were divided into three groups: group A had no muscle repair; group B underwent muscle repair; and group C had muscle repair with intramuscular nerve repair. At 7 months, groups A and B showed significantly greater muscle atrophy, replacement of muscle fiber with scar and adipose tissue, and change of muscle fiber type from a fast-twitch to a slow-twitch pattern compared to group C. A clinical case study subsequently demonstrated feasibility of intramuscular nerve repair; reinnervation of the distal belly led to rapid functional recovery. In conclusion, primary intramuscular nerve repair results in better functional outcomes following repair of lacerated muscles.
撕裂肌肉的修复常常导致恢复效果欠佳。预后不良的一个重要原因是远端节段的失神经支配。采用兔内侧腓肠肌撕裂模型来评估肌内神经修复是否能带来更好的恢复。将撕裂的兔肌肉分为三组:A组未进行肌肉修复;B组进行了肌肉修复;C组进行了肌肉修复并同时进行了肌内神经修复。7个月时,与C组相比,A组和B组出现了明显更严重的肌肉萎缩、肌纤维被瘢痕和脂肪组织替代,以及肌纤维类型从快肌纤维向慢肌纤维模式的转变。随后一项临床病例研究证明了肌内神经修复的可行性;远端肌腹的再神经支配导致了快速的功能恢复。总之,原发性肌内神经修复在撕裂肌肉修复后能带来更好的功能结果。