Development of Targeted Muscle Re-innervation ...

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Symptomatic neuromas can be extremely painful and are often present after traumatic limb amputations. Myriad of surgical techniques have been described with ...
Back to 2018 Program Development of Targeted Muscle Re-innervation model in Hind-limb Amputated Rats Rohit Garg, MD; Safak Uygur, MD; Joanna Cwykiel, MS; Maria Siemionow, MD PhD DSc; University of Illinois at Chicago, Chicago, IL INTRODUCTION

Symptomatic neuromas can be extremely painful and are often present after traumatic limb amputations. Myriad of surgical techniques have been described with conflicting results and lack of a definitive surgical managemen prostheses, has been shown to be effective in resolution of post-amputation neuroma pain in clinical studies. The purpose of this study was to develop a TMR model in hind-limb amputated rats for future assessment of neur MATERIALS and METHODS

Ten hind limbs from Five Sprague Dawley cadaver rats (250-300 g) were used for this study. Sciatic nerve, main branches of sciatic nerve (common peroneal, tibial, saphenous), motor branches from sciatic nerve to biceps f biceps femoris and femoral nerve were dissected to look for consistent nerve anatomy that can be used for TMR in the rat hind limb amputation model. Transfemoral amputation was performed and two types of coaptations w 1. Common peroneal and motor branch to biceps femoris(branch of gluteal nerve) 2. Tibial nerve and motor branch to semimembranosus(branch of gluteal nerve) RESULTS

The total surgical time for the dissection, amputation and coaptation of nerves was approximately 90 minutes. A total of 100 nerves were dissected in 10 rat hind limbs. Anatomy of the dissected nerves was consistent. Hindlengths were sufficient for coaptation without any tension. The average lengths and diameters of nerves utilized for neurotization are summarized in Table 1. CONCLUSIONS

To the best of our knowledge this is the first TMR model in hind limb amputated rats. Rat models are more readily available and cost effective. The coaptation between common peroneal and motor branch to biceps femoris a method for TMR considering the limitations in size and diameter mismatch between other donor and recipient nerves. This model will allow for mechanical, EMG and histological analysis for future assessment of neuroma pr

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