The Role of Nerve Tension on Nerve Repair Success

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Abstract

Peripheral nerve injuries that are not acutely repaired may lead to a nerve gap because of the surrounding zone of injury and elastic recoil of nerve tissue after laceration. This can result in tension across the repair site during primary neurorrhaphy. Decades of basic science literature using in vivo models consistently demonstrate a relationship between increasing strain at a neurorrhaphy site and compromised microvascular blood flow. Clinical and laboratory data suggest tension-free repairs are associated with optimal outcomes; in the setting of a short segmental nerve gap, data suggest primary repair may continue to yield good functional results. In the case of high strain, nerve grafting or other methods should be considered given poor results of primary repairs performed under high tension because of local ischemia and fibrosis on a cellular level.

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神经张力对神经修复成功的影响
周围神经损伤如果没有得到及时修复,可能会导致神经间隙,因为损伤区周围以及神经组织在撕裂后会产生弹性回缩。这可能导致在初级神经剥脱术中修复部位出现张力。数十年来使用体内模型的基础科学文献一致证明了神经出血部位应变增加与微血管血流受损之间的关系。临床和实验室数据表明,无张力修复可获得最佳效果;在短节段神经间隙的情况下,数据表明初级修复可继续产生良好的功能效果。在高应变的情况下,由于局部缺血和细胞纤维化,在高张力下进行的初次修复效果不佳,因此应考虑神经移植或其他方法。
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CiteScore
1.10
自引率
0.00%
发文量
111
审稿时长
12 weeks
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