Implantation of a nerve ending into a vein

Neuromas can be painful and physically and psychologically disabling. Among the many methods of treatment available, translocation away from noxious s timuli, such as implantation in muscle or bone, has been used. Veins are ea sily available and accessible to nerves. The outcome of a nerve ending impl anted into a vein and the effects of the implanted nerve on the vein have n ot been studied. This study evaluated neuroma prevention with a new techniq ue that involves implanting a nerve ending into a vein. The medial branches of the right femoral nerve of 20 rats were transected at midthigh level. T he distal segments were excised, The proximal segments were implanted into the femoral vein. The epineurium was sutured to the tunica adventitia using interrupted 10-0 Ethilon sutures, The left side served as controls where t he proximal nerve stumps were Left lying in their beds. The animals were sa crificed 12 weeks after the operation. Histologic analysis of 12 controls s howed neuromas. Twelve implanted nerves showed neuromas that were smaller t han those of the controls, The difference was statistically significant. Th e regenerated nerve fibers were found within the adventitia and muscular wa ll of the vein. There was no extension of nerve tissue into the vessel lume n and no thrombosis of the vein. Electron microscopic study on the other ei ght rats showed abnormal large myelinated fibers in the controls and in the implanted nerves. The fibers in the implanted group were degenerated.