Advantage of a New Epineural Nerve Repair Technique: Oblique Coaptation

ABSTRACT

In 1999 Kayikcioglu and his colleagues invented the oblique nerve coaptation technique which increases coaptation surface and proved that their technique is superior to conventional vertical coaptation technique. This method is useful but it is not fit for a clinical application because the sciatic nerve was cut obliquely and repaired immediately in their experiment. In that case, we couldn't exclude the possibility of the improved effect by increased orientation of nerve fiber. Using different nerves we could exclude the effect by orientation improvement and prove the superiority of the oblique nerve coaptation technique in functional restoration. Ten Sprague-Dawley rats were used. The tibial nerve and the peroneal nerve were cut randomly to 30 degree and 90 degree on each side. The distal stump of the tibial nerve and the proximal stump of the peroneal nerve were repaired with 10-0 nylon under microscopic view. 12 weeks after nerve coaptation, nerve conduction velocity of extensor digitorum longus muscle, moist weight and histological analysis of extensor digitorum longus muscle, and myelinated axonal count and histological analysis of peroneal nerve were investigated. The results showed the nerves of oblique coaptation(30 degree transection angle) group are more regenerated than those of vertical coaptation(90 degree transection angle) group and nerve conduction velocity and moist weight of extensor digitorum longus muscle are also increased in oblique coaptation group. From these results we came to a conclusion that the oblique nerve coaptation technique is superior to the conventional technique and may be helpful in innervated free flap or nerve graft.