Toby E B, Meyer B M, Schwappach J, Alvine G
Section of Orthopedic Surgery, University of Kansas Medical Center, Kansas City 66160-7387, USA.
J Hand Surg Am. 1996 Nov;21(6):1086-90. doi: 10.1016/S0363-5023(96)80320-0.
Changes in peripheral nerve structural properties after transection were measured weekly for 5 weeks in the distal stump of the sciatic nerve in 50 Sprague-Dawley rats. Each week after transection, the distal stump of the transected nerve showed increased stiffness when compared to intact nerves. Linear elastic stiffness reached a maximum at weeks 1 and 2 after transection, when the transected nerves were 15% stiffer than the contralateral control sides. Toughness was also increased and reached a maximum at week 4 with a 50% difference between values for experimental and control sides. Overall failure load was between 21% and 27% greater, peaking at week 3. An increase in stiffness of the distal stump would result in increased tension at the suture line, as the nerve gap is overcome when performing a delayed neurorraphy. These data suggest, with respect to structural properties, that an end-to-end repair should be carried out at the time of injury; after only 1 week, significant stiffness in the distal segment of the nerve developed, which should result in an increase in tension at the repair site.
在50只Sprague-Dawley大鼠的坐骨神经远端残端,于横断后每周测量其周围神经结构特性的变化,持续5周。横断后的每周,与完整神经相比,横断神经的远端残端硬度增加。线性弹性硬度在横断后第1周和第2周达到最大值,此时横断神经比同侧对照侧硬15%。韧性也增加,并在第4周达到最大值,实验侧与对照侧的值相差50%。总体破坏载荷增加21%至27%,在第3周达到峰值。远端残端硬度增加会导致缝合线处张力增加,因为在进行延迟神经缝合时会克服神经间隙。这些数据表明,就结构特性而言,应在损伤时进行端端修复;仅1周后,神经远端段就出现了显著的硬度增加,这会导致修复部位的张力增加。