ABSTRACT
Aberrant reinnervation of target organs caused by misdirected axonal growth at the
repair site is a major reason for the poor functional outcome usually seen after peripheral
nerve transection and repair. This study investigates whether the criss-crossing of
regenerating rat sciatic nerve axons between tibial and peroneal nerve fascicles can
be reduced by using non-vascularized autologous fascia as a barrier.
The left sciatic nerve was transected and repaired at midthigh as follows: epineurialy
sutures (Group A); fascicular repair of tibial and peroneal nerve fascicles (Group
B); fascicular repair of tibial and peroneal nerve fascicles separating the two fascicles
by non-vascularized autologous fascia (Group C). In the control Group D, only the
left tibial fascicle was transected and repaired. Five months postoperatively, the
outcome of regeneration was evaluated by histology, by retrograde tracing, and by
assessment of the contraction force of the gastrocnemius and tibial anterior muscles.
The tracing experiments showed that muscle reinnervation was less abnormal in Group
C than in Groups A and B. However, muscle contraction force was not better in Group
C than in Groups A and B. With respect to the peroneal nerve innervated muscle, the
contraction force in Group C was significantly lower than in Group B. The histologic
picture indicated that this inferior result in Group C was due to nerve compression
caused by fibrotic scar tissue at the site of the fascia graft.
Results of this study show that a non-vascularized autologous fascial graft used as
a barrier between two sutured nerve fascicles in adjacency reduces criss-crossing
of regenerating axons between the fascicles, but causes significant nerve compression.
KEYWORDS
Aberrant reinnervation - autologous fascia - sciatic nerve
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