Topographical, anatomical and neurosurgical aspects of "end-to-side" nerve repair

• DOI: 10.17816/brmma63628
• Publication Date: 2021-07-20T20:36:19Z
• Authors: A. Y. Nisht; Nikolay F. Fomin; Vladimir P. Orlov
• Keywords: Reinnervation; Epineurial repair; Motor nerve

The article presents the results of a comprehensive anatomical and experimental study individual variability in structure topography motor branches peripheral nerves relation to justification methods for selective reinnervation tissues by "end-to-side" neurorrhaphy. It was found that relatively longer with small number connecting inter-arm collaterals characteristic narrow long limbs create conditions less traumatic mobilization branches. In cases wide short extremities is complicated presence large collateral intra-trunk connections, which are often damaged when separate bundles make up mobilized donor or recipient nerve isolated from main trunk. has been shown potential should be nerves, preservation fundamental importance function corresponding segment limb. To conducive functionally significant muscle groups upper limb, we have developed, justified positions, tested an experiment on material distal idea accelerated recovery thumb opposition injuries median reinnervate muscles elevation I finger due fibers part deep branch ulnar nerve. For this purpose, surgical techniques developed recurrent at level wrist edges surgically formed perineurium defect lateral surface another clinical situation, patients radial injuries, reinnervation, а method proposed neurotisation end-to-side suture We assume performing base hand proximal damage will reduce time 400450 days. Transposition neurorrhaphy 250300 days (based total length shoulder forearm, about 50 cm rate regeneration 1 mm per day). Accordingly, higher (brachial plexus), gain segments even greater. our opinion, can used as basis further research development tissue nerves.