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End-to-side neurorrhaphy in peripheral nerves: Does it work?
J Braga Silva1, C V Busnello2, A S Becker2
1Service of Hand Surgery and Reconstructive Microsurgery, São Lucas Hospital, Centro Clinico PUCRS, Av. Ipiranga 6690, Suite 216, 90610-000 Porto Alegre, Rio Grande do Sul, Brazil.
Hand Surgery & Rehabilitation
|August 31, 2021
Summary
End-to-side neurorrhaphy shows variable efficacy for peripheral nerve reconstruction. Factors like injury type and timely intervention influence outcomes, but robust evidence remains limited.
Area of Science:
- Neurosurgery
- Regenerative Medicine
- Peripheral Nerve Injury
Background:
- Acute peripheral nerve injuries are prevalent, leading to significant sensory and functional deficits.
- Surgical intervention is often necessary for peripheral nerve reconstruction.
- End-to-side neurorrhaphy is a surgical technique used in nerve repair.
Purpose of the Study:
- To systematically review the clinical applicability of end-to-side neurorrhaphy.
- To assess the evidence base for end-to-side neurorrhaphy in peripheral nerve reconstruction.
Main Methods:
- Systematic literature review across multiple databases (MEDLINE/PubMed, EMBASE, Cochrane Library, Web of Science, Scielo, Scopus).
- Inclusion of studies published up to March 16, 2021.
- Analysis focused on qualitative data and non-randomized patient groups due to limitations in outcome assessment scales.
Main Results:
- Efficacy of end-to-side neurorrhaphy ranged from 24% to 81%.
- Favorable outcomes were associated with specific injury types, nerve characteristics (sensory, motor, mixed), epineural window presence, topography, injury extension (<1.3 cm), and early intervention (within 2 weeks).
- Statistical analysis was challenging due to study heterogeneity and lack of standardized outcome measures.
Conclusions:
- Current clinical studies provide limited scientific evidence to definitively support end-to-side neurorrhaphy for peripheral nerve lesions.
- Further high-quality research is needed to establish the efficacy and optimal application of this technique.
