An experimental comparison of the different kinds of muscle reinnervation: nerve suture, nerve implantation, and muscular neurotization.

In this experimental study, the changes in histologic pattern and functional recovery of the rectus femoris muscle of the rabbit were investigated 6 months after denervation and immediate microsurgical repair of the nerve supply of the muscle. Three different ways of reinnervation were used: nerve suture, nerve implantation directly into the muscle, and muscular neurotization by the underlying muscle. For evaluation, histochemical methods and tension measurements were used. In the results, nerve suture and nerve implantation were superior to muscular neurotization. Nevertheless, muscular neurotization was successful in all cases and led to positive EMG recordings. The functional recovery in the nerve suture and in the nerve implantation groups was astonishingly high and reached 70 to 80 percent of the tension of the control muscles. The results of this experimental study and their clinical relevance are discussed.