The Comparision Of Trunk Repair And Branch Repair Of Brachial Plexus With Root Avulsion Injury

Objective:To compare the effect of trunk repair and branch repair of root avulsion injury of brachial plexus.Methods:Thirty adult Wistar rats were used for the study. After avulsion injury model was created, they were randomly divided into three groups. In group one C3 and C4 nerve roots were used to repair C5 and C6. In group two C3 and C4 were used to repair musculocutaneous nerve of brachial plexus. In group three right brachial plexus are thoroughly cut and removed. The left upper limbs in each group were used as normal control. Three months after operation, the electromyologram of two sides' biceps brachii and deltoid in each group were detected and histological studies (H-E staining) of musculocutaneous nerve and axillary nerve were carried out after their sacrifice.esults:1,Behavior observation:After operation all right upper extremity in each group had obvious limp. In group one and group two all affected limb became straight, and couldn't leave ground when walking. Three months later after operation affected limb of group one and group two could leave ground when walking, and they could wash their face with affected limb gradually. In group three all affected limb became straight, and couldn't leave ground when walking, appeared rigor and claws became intorsion and adduction. And they couldn't lift affected limb. All these symptoms became obvious three months after operation. Four rats had wound infection after operation, and they all healed by intramuscular injection with gentamycin. Dermal ulcer appeared in 10 affected limbs and all healed. Autotomy occurred in four rats in group one, three rats in group two, two rats in group three, so they were excluded from the study.2,Electromyologram:(1), The ratio of latency of induced potential of right musculocutaneous nerve and intensity of incentive electric current:Group one and group two had significant difference in statistics (P<0.05), it was shorter in group one than group two; There was significant difference in group one and group three statistically (P<0.05) it was shorter in group one than in group three; No significant difference existed in group two and group three (P>0.05). (2), The ratio of latency of induced potential of right axillary nerve and intensity of incentive electric current:No significant difference existed in group one and group two (P>0.05);There was significant difference in group one and group three statistically (P<0.05), it was shorter in group one than in group three; Group two and group three had significant difference in statistics(P<0.05), it was shorter in group two than in group three. (3)The wave amplitude of the induced potentials in each group had no significant difference in statistics (P>0.05)3,Histological study:In group one and group two, we could find sporadic nerve fiber, axon and neural were not clear. And almost no nerve fiber was seen in group three.Conclusion:The effects of trunk repair and branch repair for root avulsion injury of brachial plexus have no significant difference in statistics.