End‐to‐side neurotization with different donor nerves for treating brachial plexus injury: An experimental study in a rat model

Introduction: End‐to‐side neurotization is currently used to treat brachial plexus injury, but it is not clear which donor nerve yields the best outcome. We performed experiments to determine the optimal donor nerve. Methods: A total of 66 male Sprague‐Dawley rats were assigned to 1 of 3 groups. Group A was the control group. In Group B, the phrenic nerve was used as the donor, while the ipsilateral C7 nerve root served as the donor in Group C. The epineurial window was used in end‐to‐side neurorrhaphy. Behavioral observations, histology, electrophysiology, and fluorescence retrotracing were performed postoperatively. Results: Fluorescence retrotracing confirmed nerve regeneration in both Groups B and C upon end‐to‐side neurotization. The outcome of Group B was superior to that of Group C. Conclusions: Use of the phrenic nerve as the donor nerve yielded a better outcome than use of the ipsilateral C7 nerve root. Muscle Nerve 50 : 67–72, 2014