Influence of Nerve Stump Transplantation Into a Vein on Neuroma Formation

In Brief The objective of this animal study was to investigate the influence of nerve stump transposition into a vein on neuroma formation. In 24 rats the femoral nerve was severed and the proximal nerve stump was transposed into the lumen of the femoral vein on one side. On the other side, the nerve was severed and left in place. The distal nerve stump was shortened to knee level on both sides. In group 1, the bloodstream was released; in group 2, the segment of the femoral vein containing the nerve stump was excluded from circulation. Histological assessment was performed 8 months later. There were significant differences between the treatment and control sides with respect to neuroma size, endoneural architecture, neural–tissue-to-connective–tissue ratio, and myelination of axons. These data suggest that nerve transposition into a vein could inhibit the formation of classic neuroma. In a rat femoral nerve-to-vein model, nerves implanted into veins were superior to controls in producing smaller neuromas that had more normal architecture, neural tissue-to-connective tissue ratio, and myelination.