Aim of the Study:The classic method used to repair nerve injuries is to place the nerve autograft in the nerve gapmaintaining the same direction it had in the harvest area. As the axon flow within the nerve cell follows a set direc-tion,this study aims to show the extent and quality of nerve regeneration in grafts where the tissue gap was bridgedusing an autograft which underwent a 180 degree rotation in respect to its original position at the donor site. Materials and Methods:As we believe that the inverted direction facilitates regeneration, we placed the graft in the nervegap rotating it 180 degrees in two different cases: 1) isolated, chronic traumatic injury of the anterior interosseous ner-ve ofthe forearm; 2) chronic injury of the median nerve of the forearm. Following the results obtained in man, wedrewup an experimental protocol for the rabbit model in order to evaluate the quality and speed of nerve regenerationboth in classic and inverted grafts by means of instrumental testing (electromyography – intraoperative electroneuro-graphy) and histological sampling. The study was performed on a New Zealand male rabbit and lasted one year. Results:The method we proposed had already lead to outstanding results in man consisting in complete and rapid nerveregeneration and reinnervation in sensory territories previously presenting defects. Our animal model confirmed ourhypothesis and the instrumental and histological results further confirmed the value of the procedure. Conclusions:Nerve repair using inverted grafts is, in our opinion, the technique to be used for chronic nerve injuries with a loss ofsubstance. Further investigation is needed to uncover the biochemical, electrical and biological mechanisms involved inthis phenomenon. Important hypotheses are presented in this paper.
|Autori:||POGGI, DS; MASSARELLA, M; CERULLI, G; CARAFFA, A; BURCHIELLI, S; MODENATO, M; CANTILE, CARLO; VOZZI, GIOVANNI; DE MARIA, CARMELO; LISANTI, MICHELE; BONICOLI, E.|
|Titolo:||La rigenerazione nervosa negli innesti a polarità invertita: dati a confronto tra applicazione sull'uomo e analisi sperimentale su modello animale|
|Anno del prodotto:||2007|
|Appare nelle tipologie:||1.1 Articolo in rivista|