59 Nerve action potential recording provides a valuable criterion selecting a qualified proximal coaptation site in nerve reconstruction

• Published in: Chirurgie de la main 2000-12, Vol.19 (6), p.332-332
• Main Authors: Meyer, V.E., Stallma, T.H., Burg, C.D.
• Format: Article
• Language: English
• ISSN: 1297-3203; 1769-6666
• DOI: 10.1016/S1297-3203(00)73556-6

Since 5 years we routinely use nerve action potential recording as described by Kline and his co-workers for the exposed nerve not only to test for spontaneous nerve regeneration across a lesion, but also as an additional criterion to assess the quality of a proximal coaptation site for grafts or direct suture. Histology was used to control for the validity of this test. The correlation between neurography and histlogy is convincing whereas assessment of the nerve cross section with the operating microscope is not reliable with regard to the number and quality of nerve fibres present at the resection site. Therefore we recommend, to apply nerve action potential recording routinely in nerve reconstruction procedures to assess the quality of the proximal coaptation site especially in chronic lesions and when distension of the nerve, inflammation, heat, chemical injury or ischaemia play a role in the pathomechanism.