PDF herunterladen
J Reconstr Microsurg 2003; 19(7): 483-488
DOI: 10.1055/s-2003-44637
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Tensile Strength of Healing Peripheral Nerves

C. L.F. Temple1 , D. C. Ross1 , C. E. Dunning2 , J. A. Johnson2 , G. J.W.  King3
  • 1Division of Plastic Surgery, University of Western Ontario
  • 2Department of Mechanical and Materials Engineering, University of Western Ontario
  • 3Division of Orthopedics, University of Western Ontario
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
24. November 2003 (online)

Auch verfügbar auf
    Lizenzen und Reprints

ABSTRACT

Although the time required for a nerve to gain sufficient strength to withstand normal physiologic forces of joint motion is unknown, typically nerve repairs are protected up to 3 weeks postoperatively. The authors investigated the mechanical strength of a nerve repair as a function of time. Fifty adult Sprague-Dawley rats underwent sciatic nerve division and repair, and were sacrificed in groups of 10 at 0, 1, 2, 4, and 8 weeks. Repaired nerves were then mechanically loaded at 5 mm/min to failure. Gapping across the repair site was captured on high-resolution video. The contralateral sciatic nerve served as a control. A significant increase in tensile strength was gained between 0 and 1 week and between 2 and 4 weeks. Healing nerves achieved 63 percent of the strength of the control by 8 weeks. Controls showed no gain in strength over the testing period. Gapping occurred at lower forces at all time increments. From 0 to 1 week, a significant increase in load necessary to produce gapping was found, which did not increase significantly again until 8 weeks. These results may have implications for postoperative rehabilitation protocols in patients with nerve injuries.

KEYWORDS

Nerve repair - neurorrhaphy - tensile strength - rat sciatic nerve

REFERENCES

  • 1 Altimissi A, Mancini G B, Azarra A. Results of primary repair of digital nerves.  J Hand Surg . 1991;  16B 546-547
    PubMedSuche in Google Scholar
  • 2 Efstathopoulos D, Gerostathopoulos N, Misitzis D, Bouchlis G, Anagnostou S, Daoutis N K. Clinical assessment of primary digital nerve repair.  Acta Orthop Scand Suppl . 1995;  264 45-47
    PubMedSuche in Google Scholar
  • 3 Young L, Wray R C, Weeks P M. A randomized prospective comparison of fascicular and epineurial digital nerve repairs.  Plast Reconstr Surg . 1981;  68 89-93
    PubMedSuche in Google Scholar
  • 4 Birch R, Raji A RM. Repair of median and ulnar nerves. Primary suture is best.  J Bone Joint Surg . 1991;  73B 154-157
    PubMedSuche in Google Scholar
  • 5 Deutinger M, Girsch W, Burggasser G. et al . Peripheral nerve repair in the hand with and without motor sensory differentiation.  J Hand Surg . 1993;  18A 426-432
    PubMedSuche in Google Scholar
  • 6 Jongen S J, Van Twisk R. Results of primary repair of ulnar and median nerve injuries at the wrist: an evaluation of sensibility and motor recovery.  Neth J Surg . 1988;  40 86-89
    PubMedSuche in Google Scholar
  • 7 Lijftogt H J, Dijkstra R, Storm van Leewen B J. Results of microsurgical treatment of nerve injuries of the wrist.  Neth J Surg . 1987;  39 170-174
    PubMedSuche in Google Scholar
  • 8 Mackinnon S E, Dellon A L. Surgery of the Peripheral Nerve. New York: Thieme Medical Publishers 1988: 89-129
    Suche in Google Scholar
  • 9 Rogers G D, Henshall A L, Sach R P, Wallis K A. Simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist.  J Hand Surg . 1990;  15A 990-995
    PubMedSuche in Google Scholar
  • 10 Chiu D TW, Ishii C. Management of peripheral nerve injuries.  Orthoped Clin N Am . 1986;  17 365-373
    PubMedSuche in Google Scholar
  • 11 Brushart T M. Nerve repair and grafting. In: Green DP, Hotchkiss RN, Pederson WC, eds. Green's Operative Hand Surgery, 4th ed Philadelphia: Churchill Livingstone 1991: 1381
    Suche in Google Scholar
  • 12 Smith K L. Nerve response to injury and repair. In: Hunter JM, Macking EJ, Callahan AD, eds. Rehabilitation of the Hand: Surgery and Therapy, 4th ed St Louis, MO: Mosby 1995: 609-626
    Suche in Google Scholar
  • 13 Lundborg G. Nerve regeneration. In: Lundborg G, ed. Nerve Injury and Repair New York: Churchill Livingstone 1988: 149-195
    Suche in Google Scholar
  • 14 Kwan M K, Woo S LY. Biomechanical properties of peripheral nerve. In: Gelberman R, ed. Operative Nerve Repair and Reconstruction Philadelphia: JB Lipincott 1991: 47-54
    Suche in Google Scholar
  • 15 Tarlov I M. How long should an extremity be immobilized after nerve suture?.  Ann Surg . 1947;  126 366
    PubMedSuche in Google Scholar
  • 16 Mukherjee S R. Tensile strength of nerves during healing.  Br J Surg . 1953;  1992 192
    PubMedSuche in Google Scholar
  • 17 Higgs P E, Weeks P M. The rate of bursting strength gain in repaired nerves.  Ann Plast Surg . 1979;  3 338-340
    PubMedSuche in Google Scholar
  • 18 Abrams R A, Butler J M, Bodine-Fowler S, Botte M J. Tensile properties of the neurorrhaphy site in the rat sciatic nerve.  J Hand Surg . 1998;  23 465-470
    PubMedSuche in Google Scholar
  • 19 Levenson S M, Geever E F, Crowley L V, Oates III F J, Berard C W, Rosen H. The healing of rat skin wounds.  Ann Surg . 1965;  161 293
    CrossrefPubMedSuche in Google Scholar
  • 20 Giddins G E, Wade P J, Amis A A. Primary nerve repair: strength of repair with different gauges of nylon suture material.  J Hand Surg . 1989;  14B 301-302
    PubMedSuche in Google Scholar
  • 21 Silfverskiold K L, Andersson C H. Two new methods of tendon repair: an in vitro evaluation of tensile strength and gap formation.  J Hand Surg . 1993;  18 58-65
    CrossrefPubMedSuche in Google Scholar
  • 22 Taras J S, Gray R M, Culp R W. Complications of flexor tendon injuries.  Hand Clin . 1994;  10 93-109
    PubMedSuche in Google Scholar