الفهرس 
Peripheral nerve anatomy and physiologyOnly 14 pages are availabe for public view
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Abstract
Peripheral nerves are specialized tissues that transmit an electric
current, receiving sensory input, sending motor commands, as well as
autonomic in and out flow. They consist of neural and non-neural tissues.
When injured they have the capacity to regenerate in orchestrated events
occurring at the site of injury, distal, proximal segments and terminal
receptors.
Peripheral nerve injuries have a devastating outcome if not managed
properly. An insensate immobile limb may encounter many problems to the
patient requiring amputation. The primary nerve repair is the preferred
technique wherever possible. The autogenous nerve graft is still the gold
standard in overcoming a nerve gap.
Nerve transfer or ETSN are two different techniques of nerve repair
used particularly in specific situations of peripheral nerve injuries. Several
experimental works and clinical application were done on both techniques.
The main advantage of nerve transfer is end to end repair, although there is
complete sacrification of the donor end organ. In ETSN the down grading of
the donor nerve is usually negligible, but the functional outcomes in previous
studies are controversial especially when compared to the end to end
technique. Probably this varied from hand to hand and according to the
donor nerve size. Other many issues about ETSN are still unclear and
debatable as the sensory and motor sprouting, and the prerequisite for donor
axonal injury.The aim of this work was to compare the efficacy of motor nerve
transfer and end to side neurorrhaphy either by mixed nerve or motor nerve.
Sixty Wister rat weighting 200-300 g were divided into six groups. group I
is normal control, group II was denervated control where the Cranial tibial
muscle (CTM) was denervated by cutting the peroneal nerve, In groups III
ETS between the peroneal nerve and side of the tibial nerve (mixed nerve)
was created, while in group IV an ETE of the peroneal nerve (mixed nerve)
was done. The ETE between motor branch of the lateral head of
gastrocnemius muscle (LGCM) and peroneal nerve (mixed nerves) was
performed in group V, and in group VI an ETS between Peroneal nerve
(mixed nerve) and motor branch of LGCM (motor nerve) was created. After
60 and 120 (time of sacrification) days walking track analysis and peroneal
functional index (PFI), mid leg circumference, EMG, forced muscle
contraction (FMC), muscle weight, muscle width, and histomorphometry of
the nerves and muscles were done. In all the groups the CTM was examined,
while the LGCM only examined in groups I, III, V and VI to evaluate the
effect on the muscle supplied by the donor nerve.
The results of the different evaluation methods revealed that, the four
experimental groups fell in between the normal control and denervated
contro groupsl. The best experimental group was IV (ETE with mixed nerve)
and the worst was group VI (ETS with motor nerve). Comparing the CTMs
in groups III (ETS with mixed nerve) and V (ETE with motor nerve) showed
no significant difference in all the parameters. In group V (ETE with motor
nerve) the muscle supplied by the donor nerve was completely lost, while in
group III the muscle (LGCM) supplied by the donor nerve showed no
significant difference from the control muscles. These results gave the
advantage of ETS with mixed nerve over the ETE with motor nerve (nerve
transfer), due to donor muscle preservation.