End‐to‐side neurorraphy: A long‐term study of neural regeneration in a rat model

This study evaluated long‐term reinnervation of an end‐to‐side neurorraphy and the resultant functional recovery in a rat model. The divided distal posterior tibial nerve was repaired to the side of an intact peroneal nerve. Control groups included a cut‐and‐repair of the posterior tibial nerve and an end‐to‐end repair of the peroneal nerve to the posterior tibial nerve. Evaluations included walking‐track analysis, nerve conduction studies, muscle mass measurements, retrograde nerve tracing, and histologic evaluation. Walking tracks indicated poor recovery of posterior tibial nerve function in the experimental group. No significant difference in nerve conduction velocities was seen between the experimental and control groups. Gastrocnemius muscle mass measurements revealed no functional recovery in the experimental group. Similarly, retrograde nerve tracing revealed minimal motor neuron staining in the experimental group. However, some sensory staining was seen within the dorsal root ganglia of the end‐to‐side group. Histologic study revealed minimal myelinated axonal regeneration in the experimental group as compared with findings in the other groups. These results suggest that predominantly sensory regeneration occurs in an end‐to‐side neurorraphy at an end point of 6 months.