Microhook Nerve Connector Cable Grafting: A Cadaveric Study of Biomechanical Integrity

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Materials Science

Background:

• Peripheral nerve defects often require cable grafting, a technique demanding extensive microsurgical suturing.
• Microsuturing increases operative time and foreign body burden.
• A novel microhook nerve connector (MNC) offers a potential sutureless alternative for nerve repair.

Purpose of the Study:

• To evaluate the biomechanical integrity of microhook nerve connector (MNC) cable grafting compared to traditional microsutures.
• To test the hypothesis that MNC cable grafts provide greater holding strength than microsuture repairs.

Main Methods:

• 16 cadaveric nerves (5-6 mm diameter) underwent cable grafting with either MNC or microsutures.
• 64 smaller nerves (1.5-2 mm diameter) were used to create 4-strand cable grafts.
• Biomechanical integrity was assessed using tensile testing to determine load to failure.

Main Results:

• MNC-assisted repairs showed significantly higher maximum load to failure (3.05 ± 0.57 N) than microsuture repairs (1.55 ± 0.53 N).
• MNC repairs sustained higher loads at each sequential failure peak.
• Nerve strands in MNC repairs remained entubulated during failure, maintaining proximity.

Conclusions:

• MNC cable grafts exhibit superior biomechanical holding strength compared to microsuture repairs.
• The MNC provides a sutureless alternative for cable grafting.
• Further investigation of MNC-assisted cable grafting for clinical application is warranted.