Free grafting of saphenous nerve with great saphenous arteriotization : an experimental study

Objective To provide anatomic and experimental basis for clinical application of saphenous nerve with vascularity. Methods The saphenous nerve and its blood vessels were measured in 36 side adult cadaver legs injected with emulsion and 6 side fresh ones with ink. 40 Chinese adult dogs were involved , with 10 in each. They were divided into 4 groups: group of great saphenous ateriotization, group of anastomosis between artery and vein , group of nerve grafting without vessels and group without anastomosis .The result after nerve grafting was observed. Results The length of saphenous nerve between the perforation of deep facia and the superficial point of the medial malleolus was (38.19 ± 2.06) cm. The upper part of saphenous nerve was supplied by saphenous artery, while the middle and lower parts norished by intermuscular septum perforating branches of posterior tibial artery and medial tarsal artery. Vessel network was formed among those nutrient artery in an anastomosis way. The network between reflowing vein and great saphenous vein flowed back into the latter. The saphenous nerve always lay posterior to great saphenous vein. There was no statistical difference in nerve regeneration between arteriortization and anastomosis group. But both group were superior to the group without vessels. Conclusions The saphenous nerve grafting may be done in a pedicled saphenous artery way, or in a great saphenous arteriotization way. The procedures are simple and practical , which supply a satisfactory donor for treatment of long nerve defect.