Skoulis T G, Lovice D, von Fricken K, Terzis J K
Division of Plastic Surgery, Eastern Virginia Medical School, Norfolk, USA.
Clin Orthop Relat Res. 1995 May(314):84-94.
Treatment of the short nerve gap remains a challenge for the reconstructive surgeon, but it is a clinical problem that can be addressed by nerve expansion. In the present study, the effects of slow nerve expansion on the walking behavior of the rat were examined. When expansion was applied on a normal sciatic nerve or on a transected nerve at either the proximal or the distal segments, permanent 30% elongation could be achieved. The recovered function from the expanded nerve stumps was compared with such classical methods of nerve reconstruction as nerve graft, coaptation under moderate tension, and tensionless repair. The results compared favorably between the expanded groups and the time-honored methods of nerve repair. Analysis of the behavioral data indicated that any amount of expansion affected the functional capabilities of the involved nerve. However, expansion of a normal nerve and/or proximal segment of a transected nerve was better tolerated than distal segment expansion, which suggests that the presence of an axon may have a beneficial effect in minimizing the deforming mechanical insult. Slow nerve expansion appears to have a definite role in the microsurgical management of the short nerve gap.
对于重建外科医生而言，治疗短神经缺损仍是一项挑战，但这是一个可通过神经扩张解决的临床问题。在本研究中，研究了缓慢神经扩张对大鼠行走行为的影响。当对正常坐骨神经或在近端或远端横断的神经进行扩张时，可实现30%的永久性伸长。将扩张神经残端恢复的功能与神经移植、适度张力下吻合以及无张力修复等经典神经重建方法进行了比较。扩张组与传统神经修复方法的结果相比更具优势。行为数据分析表明，任何程度的扩张都会影响受累神经的功能能力。然而，正常神经和/或横断神经近端段的扩张比远端段扩张耐受性更好，这表明轴突的存在可能对最小化变形机械损伤具有有益作用。缓慢神经扩张似乎在短神经缺损的显微外科治疗中具有明确作用。
