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Nerve regeneration after terminolateral neurorrhaphy: experimental study in rats.

Four methods of nerve terminolateral neurorrhaphy (TLN) were studied in rat experimental model. In Group A, the distal end of a severed peroneal nerve was sutured end-to-side with an intact tibial nerve trunk, without removal of the tibial epineurium at the suture site. In Group B, the distal end of a severed peroneal nerve was sutured end-to-side with the intact tibial nerve trunk, with removal of the tibial epineurium at the suture site. In Group C, a nerve segment was bridged between the distal part of the severed peroneal nerve and the intact tibial nerve with two end-to-side sutures. In Group D, the proximal end of a severed tibial nerve was sutured end-to-side with the peroneal nerve trunk. Through electrophysiologic, histologic, and ultrastructural examinations, the following conclusions were drawn: 1. Nerve regeneration is possible after TLN. 2. The regenerating fibers after TLN have the ability to penetrate the endoneurium, perineurium, and epineurium. 3. After different methods of TLN, the regenerating fibers grow in both a flowing-out and a filling-in fashion.