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The peroneal nerve of dogs was exposed and transected. With proper microsurgical instruments and techniques, a nerve segment 10mm long was removed from the peroneal nerve at mid-thigh followed by a primary termino-terminal nerve employing an autogenous venous patch (obtained from the safenous vein of the same side) to avoid tension at the nerve interface. The vein segment 15 mm in average length, was longitudinally sectioned and sutured initially to the proximal nerve stump, having the vein endothelium envelop two-thirds of the nerve’s circumference and at a distance of 6-7 mm proximally to the cut nerve surface. Four 8/0 nylon interrupted stitches were placed at the end the patched vein thus suturing the latter to the external epineurium. Additional stitches were placed along the nerve-vein interface, from proximally to distally, up to 3 mm from the proximal stump’s end. The distal end of the vein was then grasped and gently stretched, tractioning the proximal nerve stump with it. The free vein surface was placed against the posterior surface of  the distal nerve stump after adequate longitudinal traction had fully elongated the vein’s elasticity. It was sutured as distally to the nerve’s posterior surface as possible and after enough traction had been applied to the distal nerve stump so as to coapt both nerve ends.

The number of myelinated axons in the sections was determined with a computer-controlled system (Biographics).There was no signifcant difference between the mean number of axons or in “G” ratio, present in the proximal and distal portions of the nerves. Also, there was no significant difference in the mean number of myelinated fibers.

Others nerves  were used to compare the biomechanical behavior of the common peroneal nerves that underwent repair by the proposed surgical (n=19) to the ones with an end-to-end suture under tension (n=19), by applying progressively greater longitudinal loads on specimen. The results showed that the proposed surgical technique has higher rigidity and maximum resistance of at least twice as high as that of the end-to-end suture under tension.  

These data will add support and understanding to the encouraging clinical results obtained in 16 patients operated on with the described technique by the author since 1989, and in which, the average nerve gap in median and ulnar nerves in the forearm of adults was 36 mm.