COMPARISON OF HEALING RESULTS BETWEEN TIBIAL NERVE AND COMMON PERONEAL NERVE AFTER SCIATIC NERVE INJURY REPAIR IN RHESUS MONKEY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGQiang , CHENHuihao , LIUGuohui , ZONGHaiyang , LINHaodong ,  HOUChunlin

Department of Orthopaedics, Changzheng Hospital of Second Military Medical University, Shanghai, 200003, P. R. China;

Corresponding author：

HOUChunlin, Email: chunlin_hou@163.com

Keywords：

Sciatic nerve injury; Common peroneal nerve; Tibial nerve; Nerve regeneration; Rhesue monkey

DOI：

10.7507/1002-1892.20160123

Video：

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Objective To investigate the regularity of myelin degeneration and regeneration and the difference of axonal density between tibial nerve and common peroneal nerve after sciatic nerve injury repair in rhesue monkey. Methods Nine adult rhesue monkeys (male or female, weighing 3.5-4.5 kg) were selected to establish the model of rat sciatic nerve transaction injury. The tibial nerve and common peroneal nerve of 5 mm in length were harvested at 5 mm from injury site as controls in 3 monkeys; the distal tibial nerve and common peroneal nerve were repaired with 9-0 suture immediately in the other 6 monkeys. And the gross observation and neural electrophysiological examination were performed at 3 and 8 weeks after repair respectively. Then, distal tibial nerve and common peroneal nerve at anastomotic site were harvested to observe the myelin sheath changes, and to calculate the number of axon counts and axonal density by staining with Luxol Fast Blue. Results Atrophy of the lower limb muscle and various degrees of plantar ulcer were observed. Gross observation showed nerve enlargement at anastomosis site, the peripheral connective tissue hyperplasia, and obvious adhesion. The compound muscle action potential (CMAP) of tibial nerve and common peroneal nerve could not be detected at 3 weeks; the CMAP amplitude of common peroneal nerve was less than that of the tibial nerve at 8 weeks. Different degrees of axonal degeneration was shown in the tibial nerve and common peroneal nerve, especially in the common peroneal nerve. The average axonal density of common peroneal nerve was lower than that of tibial nerve at 3 weeks (13.2% vs. 44.5%) and at 8 weeks (10.3% vs. 35.3%) after repair. Conclusion The regeneration of tibial nerve is better and faster than that of common peroneal nerve, and gastrocnemius muscle CMAP recovers quicker, and amplitude is higher, which is the reason of better recovery of tibial nerve.

Citation： ZHANGQiang, CHENHuihao, LIUGuohui, ZONGHaiyang, LINHaodong, HOUChunlin. COMPARISON OF HEALING RESULTS BETWEEN TIBIAL NERVE AND COMMON PERONEAL NERVE AFTER SCIATIC NERVE INJURY REPAIR IN RHESUS MONKEY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 608-611. doi: 10.7507/1002-1892.20160123 Copy

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2.	Quick TJ, Macquillan A, Sinisi M, et al. The examination and management of nerve injury in supracondylar fractures of the humerus. J Pediatr Orthop B, 2013, 22(4):397-398.
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4.	陈焱, 肖志宏, 邢丹谋. 周围神经损伤再生与修复的研究进展. 中华显微外科杂志, 2015, 38(4):413-416.
5.	Gousheh J, Arasteh E, Beikpour H. Therapeutic results of sciatic nerve repair in Iran-Iraq war casualties. Plast Reconstr Surg, 2008, 121(3):878-886.
6.	George SC, Boyce DE. An evidence-based structured review to assess the results of common peroneal nerve repair. Plast Reconstr Surg, 2014, 134(2):302e-311e.
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11.	Wood MB. Peroneal nerve repair. Surgical results. Clin Orthop Relat Res, 1991, (267):206-210.
12.	任继鑫, 刘树清, 刘智, 等. 髋臼骨折脱位合并坐骨神经损伤的治疗和预后. 中国骨与关节损伤杂志, 2010, 25(1):9-12.
13.	马金刚. 髋臼骨折、髋关节脱位合并坐骨神经损伤46例临床分析. 中国现代药物应用, 2014, 8(12):74-75.
14.	谢颍涛, 顾立强, 林晓岗. 髋臼骨折、髋关节脱位合并坐骨神经损伤的临床分析. 中华创伤骨科杂志, 2005, 7(7):660-663.
15.	曹述铁, 饶利兵, 胡祥上, 等. 腓总神经与腓骨颈的关系及其小腿各肌支的解剖学研究. 解剖学研究, 2004, 26(4):292-293, 297.
16.	孙津民, 李兆祥, 林子蔚, 等. 坐骨神经损伤多见腓总神经病变原因分析及临床意义. 中国临床解剖学杂志, 2006, 24(2):163-165.
17.	Çinar A, Yumrukçal F, Salduz A, et al. A rare cause of "drop foot" in the pediatric age group:Proximal fibular osteochondroma a report of 5 cases. Int J Surg Case Rep, 2014, 5(12):1068-1071.
18.	DeVetten G, Coutts SB, Hill MD, et al. Acute corticospinal tract Wallerian degeneration is associated with stroke outcome. Stroke, 2010, 41(4):751-756.
19.	姚东东, 张洁元, 刘彬, 等. 周围神经损伤修复微环境的研究进展. 中国修复重建外科杂志, 2015, 29(9):1167-1172.

1. Ultee J, Hundepool CA, Nijhuis TH, et al. Early posttraumatic psychological stress following peripheral nerve injury:a prospective study. J Plast Reconstr Aesthet Surg, 2013, 66(10):1316-1321.
2. Quick TJ, Macquillan A, Sinisi M, et al. The examination and management of nerve injury in supracondylar fractures of the humerus. J Pediatr Orthop B, 2013, 22(4):397-398.
3. He B, Zhu Z, Zhu Q, et al. Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries. Neural Regen Res, 2014, 9(6):661-672.
4. 陈焱, 肖志宏, 邢丹谋. 周围神经损伤再生与修复的研究进展. 中华显微外科杂志, 2015, 38(4):413-416.
5. Gousheh J, Arasteh E, Beikpour H. Therapeutic results of sciatic nerve repair in Iran-Iraq war casualties. Plast Reconstr Surg, 2008, 121(3):878-886.
6. George SC, Boyce DE. An evidence-based structured review to assess the results of common peroneal nerve repair. Plast Reconstr Surg, 2014, 134(2):302e-311e.
7. Faroni A, Mobasseri SA, Kingham PJ, et al. Peripheral nerve regeneration:Experimental strategies and future perspectives. Adv Drug Deliv Rev, 2015, 82-83:160-167.
8. Câmara CC, Araujo CV, de Sousa KK, et al. Gabapentin attenuates neuropathic pain and improves nerve myelination after chronic sciatic constriction in rats. Neurosci Lett, 2015, 607:52-58.
9. Seidel JA, Koenig R, Antoniadis G, et al. Surgical treatment of traumatic peroneal nerve lesions. Neurosurgery, 2008, 62(3):664-673.
10. Korompilias AV, Payatakes AH, Beris AE, et al. Sciatic and peroneal nerve injuries. Microsurgery, 2006, 26(4):288-294.
11. Wood MB. Peroneal nerve repair. Surgical results. Clin Orthop Relat Res, 1991, (267):206-210.
12. 任继鑫, 刘树清, 刘智, 等. 髋臼骨折脱位合并坐骨神经损伤的治疗和预后. 中国骨与关节损伤杂志, 2010, 25(1):9-12.
13. 马金刚. 髋臼骨折、髋关节脱位合并坐骨神经损伤46例临床分析. 中国现代药物应用, 2014, 8(12):74-75.
14. 谢颍涛, 顾立强, 林晓岗. 髋臼骨折、髋关节脱位合并坐骨神经损伤的临床分析. 中华创伤骨科杂志, 2005, 7(7):660-663.
15. 曹述铁, 饶利兵, 胡祥上, 等. 腓总神经与腓骨颈的关系及其小腿各肌支的解剖学研究. 解剖学研究, 2004, 26(4):292-293, 297.
16. 孙津民, 李兆祥, 林子蔚, 等. 坐骨神经损伤多见腓总神经病变原因分析及临床意义. 中国临床解剖学杂志, 2006, 24(2):163-165.
17. Çinar A, Yumrukçal F, Salduz A, et al. A rare cause of "drop foot" in the pediatric age group:Proximal fibular osteochondroma a report of 5 cases. Int J Surg Case Rep, 2014, 5(12):1068-1071.
18. DeVetten G, Coutts SB, Hill MD, et al. Acute corticospinal tract Wallerian degeneration is associated with stroke outcome. Stroke, 2010, 41(4):751-756.
19. 姚东东, 张洁元, 刘彬, 等. 周围神经损伤修复微环境的研究进展. 中国修复重建外科杂志, 2015, 29(9):1167-1172.

Chinese Journal of Reparative and Reconstructive Surgery

COMPARISON OF HEALING RESULTS BETWEEN TIBIAL NERVE AND COMMON PERONEAL NERVE AFTER SCIATIC NERVE INJURY REPAIR IN RHESUS MONKEY

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