%0 Journal Article
%T Novel model for end-neuroma formation in the amputated rabbit forelimb
%A Peter S Kim
%A Jason Ko
%A Kristina K O'Shaughnessy
%A Todd A Kuiken
%A Gregory A Dumanian
%J Journal of Brachial Plexus and Peripheral Nerve Injury
%D 2010
%I Thieme Medical Publishers
%R 10.1186/1749-7221-5-6
%X Upon approval from the Institutional Animal Care and Use Committee, 5 New Zealand White rabbits underwent left forelimb amputation. During this initial surgery, the median, radial and ulnar nerves were transected 1.6-2.5 (mean 2.0) cm distal to the brachial plexus, transposed onto the anterior chest wall and preserved at length. Six weeks subsequent to the amputation, the distal 5 mm of each neuroma was excised, and the remaining stump underwent histomorphometric analysis.The nerve cross sectional areas increased by factors of 1.99, 3.17, and 2.59 in the median (p = 0.077), radial (p < 0.0001) and the ulnar (p = 0.0026) nerves, respectively. At the axonal level, the number and cross-sectional area of myelinated fibers demonstrated an inverse relationship whereby the number of myelinated fibers in the median, radial and ulnar nerves increased by factors of 5.13 (p = 0.0043), 5.25 (p = 0.0056) and 5.59 (p = 0.0027), and the cross-sectional areas of these myelinated fibers decreased by factors of 4.62 (p < 0.001), 3.51 (p < 0.01), and 4.29 (p = 0.0259), respectively.Given that the surgical model appears well-tolerated by the rabbits and that patterns of morphologic change are consistent and reproducible, we are encouraged to further investigate the utility of this model in the pathogenesis of neuroma formation.In the modern era of military combat, there is an increasing incidence of extremity amputations [1], and though advances in body armor and trauma resuscitation have allowed soldiers to survive previously mortal wounds, the cost of survival is often a mangled or amputated extremity. Neuroma formation from amputated nerve stumps can create a challenging clinical scenario since successful treatment of painful neuromas is often elusive [2-4], due in part to the activity of the regenerating nerve fibers at the amputation site.Two key histologic characteristics of the end-neuroma are the sprouting of nerve fibers in the regenerating growth cone and a preponderance of d
%U http://www.jbppni.com/content/5/1/6