Advertisement
Research Article| Volume 46, ISSUE 7, P557-564, 1993

Repair of mixed peripheral nerves using muscle autografts: a preliminary communication

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Twelve patients were reviewed following the reconstruction of mixed motor/sensory nerves using freeze-thawed skeletal muscle autografts. A total of 13 nerves were reconstructed—6 median and 7 ulnar. All the repairs were secondary procedures, with a mean time from injury to grafting of 17 months. Sensory and motor evaluation was carried out and the patients asked to complete a pain questionnaire. Five patients achieved an S3 + level of sensory recovery. Two underwent revision of their muscle grafts to nerve grafts. Motor recovery was universally poor.

      Reference

        • Seddon HJ
        Nerve grafting.
        J Bone Joint Surg. 1963; 45B: 447-461
        • Lundborg G
        • Dahlin LB
        • Danielsen N
        Ulnar nerve repair by the silicone chamber technique.
        Scand J Plast Reconstr Hand Surg. 1991; 25: 79-82
        • Norris RW
        • Glasby MA
        • Gattuso JM
        • Bowden REM
        Peripheral nerve repair in humans using muscle autografts.
        J Bone Joint Surg. 1988; 70B: 530-533
        • Davies AH
        • De Souza BA
        • Gattuso JM
        • Glasby MA
        • Gschmeissner SE
        • Huang CL-H
        Peripheral nerve growth through differently orientated muscle matrices.
        Neuro-Orthopaedics. 1987; 4: 62-73
        • Glasby MA
        • Gschmeissener SE
        • Hitchcock RJI
        • Huang CL-H
        The dependence of nerve regeneration through muscle grafts in the rat on the availability and orientation of basement membrane.
        J Neurocytol. 1986; 15: 497-510
        • Ide C
        • Tohyama K
        • Yokota R
        • Nitatori T
        • Onodera S
        Schwann cell basal lamina and nerve regeneration.
        Brain Res. 1983; 288: 61-75
        • Ide C
        Nerve regeneration through the basal lamina scaffold of the skeletal muscle.
        Neurosci Res. 1984; 1: 379-391
        • Tohyama K
        • Ide C
        The localization of laminin and fibronectin on the Schwann cell basal lamina.
        Archives of Histology of Japan. 1984; 47: 519-532
        • Keynes RJ
        • Hopkins WG
        • Huang CL-H
        Regeneration of mouse peripheral nerves in degenerating skeletal muscle: guidance by residual muscle fibre basement membrane.
        Brain Res. 1984; 295: 275-281
        • Tohyama K
        The localization of lectin-binding sites on Schwann cell basal lamina.
        J Neurocytol. 1985; 14: 49-61
        • Fawcett JW
        • Keynes RJ
        Muscle basal lamina: a new graft material for peripheral nerve repair.
        J Neurosurg. 1986; 65: 354-363
        • Glasby MA
        Nerve growth in matrices of orientated muscle basement membrane: developing a new method of nerve repair.
        Clinical Anatomy. 1990; 3: 161-182
        • Melzack R
        The McGill pain questionnaire: major properties and scoring methods.
        Pain. 1975; 1: 277-299
        • Dellon AL
        • Mackinnon SE
        • Crosby PM
        Reliability of two-point discrimination measurements.
        J Hand Surg [Am]. 1987; 12A: 693-696
        • Levin S
        • Pearsall G
        • Ruderman RJ
        Von Frey's method of measuring pressure sensibility in the hand: an engineering analysis of the Weinstein-Semmes pressure aesthesiometer.
        J Hand Surg. 1978; 3: 211-216
        • Smith PJ
        • Mott G
        Sensory threshold and conductance testing in nerve injuries.
        J Hand Surg. 1986; 11B: 157-162
        • Hems TEJ
        • Glasby MA
        Comparison of different methods of repair of long peripheral nerve defects: an experimental study.
        Br J Plast Surg. 1992; 45: 497-502
        • Steinberg DR
        • Koman LA
        Factors affecting the results of peripheral nerve repair.
        in: Gelberman RH Operative nerve repair and reconstruction. JB Lippincott, Philadelphia1991: 349-364
        • Zachary RB
        Results of nerve suture.
        in: Seddon HJ Peripheral nerve injuries. Medical Research Council Special Report No. 282. Her Majesty's Stationery Office, London1954: 354-388
        • Bowden REM
        • Gutmann E
        Denervation and reinnervation of human voluntary muscle.
        Brain. 1944; 67: 273-313
        • Gutmann E
        Factors affecting recovery of motor function after nerve lesions.
        Journal of Neurology and Psychiatry. 1942; 5: 81-95
        • Holmes W
        • Young JZ
        Nerve regeneration after immediate and delayed suture.
        J Anat. 1942; 77: 63-106
        • Giannini C
        • Dyck PJ
        The fate of schwann cell basement membranes in permanently transected nerves.
        J Neuropathol Exp Neurol. 1990; 49: 550-563
        • Abercrombie M
        • Johnson ML
        The outwandering of cells in tissue cultures of nerves undergoing wallerian degeneration.
        J Exp Biol. 1942; 19: 266-283
        • Weinberg HJ
        • Spencer PS
        The fate of schwann cells isolated from axonal contact.
        J Neurocytol. 1978; 7: 555-569
        • Nathaniel EJH
        • Pease DC
        Collagen and basement membrane formation by schwann cells during nerve regeneration.
        Journal of Ultrastructural Research. 1963; 9: 550-560
        • Thomas PK
        The deposition of collagen in relation to schwann cell basement membrane during peripheral nerve regeneration.
        J Cell Biol. 1964; 23: 375-383
        • Glasby MA
        • Gschmeissner SE
        • Hitchcock RJI
        • Huang CL-H
        • De Souza BA
        Comparison of nerve regeneration through nerve and muscle grafts in rat sciatic nerve.
        Neuro-Orthopaedics. 1986; 2: 21-28
        • Glasby MA
        • Gschmeissner SE
        • Huang CL-H
        • De Souza BA
        Degenerated muscle grafts used for peripheral nerve repair in primates.
        J Hand Surg. 1986; 11B: 347-351
        • Gattuso JM
        • Glasby MA
        • Gschmeissner SE
        • Norris RW
        A comparison of immediate and delayed repair of peripheral nerves using freeze-thawed autologous skeletal muscle grafts—in the rat.
        Br J Plast Surg. 1989; 42: 306-313
        • Mackinnon SE
        • Dellon AL
        Surgery of the peripheral nerve.
        in: Thieme, New York1988: 115-129
        • Novak CB
        • Kelly L
        • Mackinnon SE
        Sensory recovery after median nerve grafting.
        J Hand Surg [Am]. 1992; 17A: 59-68