[Longitudinal excursion of the sciatic nerve: an experimental study in the adult rat]

Every nerve must have the capacity to adapt to different positions by passive movement relative to the surrounding tissue. This capacity is called longitudinal excursion (LE). The LE of the sciatic nerve has been studied in 40 Wistar rats. The LE was measured, the nerve was cut, sutured, a metallic body was put into the anastomotic site for later radiographic controls (at the 8th week) and then the anastomosis was protected with different kinds of tissue. After 16 weeks the sciatic nerve was exposed, the LE was measured again and the nerve was dissected out for light microscopy. The LE is produced by two mechanisms: 1) rectification of the undulating course of the nerve and 2) elasticity of the neural connective tissue sheaths. The paraneurim provides a gliding tissue. During flexion movements, it acts as an external support and keeps the nerve under a longitudinal compression force. The normal LE is the release of this compression. These properties enable the nerve to glide without changing its diameter. The gag after nerve section is approximately 75% of LE. After repairing the nerve the new LE is 55% of the original value. In peripheral nerve surgery, to create a new nerve-bed or to protect the anastomoses, a muscle flap should be avoided. On the other hand, no difference could be found between other tissue flaps. When transposing a nerve, the submuscular position is preferable to the intramuscular position.