Stretch injury of peripheral nerve. Acute effects of stretching on rabbit nerve.

1. Forty-seven tibial nerves of rabbits were stretched, twenty-four gradually by the Instron machine and twenty-three suddenly by dropping a load. The stretched nerves were examined histologically throughout their length. 2. Nerve trunks possess a high degree of elasticity, which is mainly a feature of the epineurium. 3. The initial elongation of the nerve is due to extension of the epineurium and straightening of the funiculi and of the nerve fibres. Such elongation is "physiological" in the sense that it does not affect the nerve fibres. 4. The first structure to be ruptured during stretching is the epineurium ; this occurs when the nerve trunk has reached its limit of elasticity. 5. Before rupture of the epineurium the damage to the nerve fibres is either neurapraxia or axonotmesis, because the endoneurial sheaths and Schwann tubes remain intact. 6. Beyond the limit of elasticity very severe damage of the nerve trunk occurs; all elements of the nerve may be ruptured. If less violent force is applied, some funiculi may survive. The longitudinal extent of the lesion is always great, reaching 2 to 5 centimetres in the rabbit.

[1]  W. Penfold.  On Injuries to Peripheral Nerves. (Pract., Aug., 1899.) Horsley, V. , 1900 .

[2]  H. Platt.  TRACTION LESIONS OF THE EXTERNAL POPLITEAL NERVE , 1940 .

[3]  Peripheral Nerve Injuries , 1941 .

[4]  H. J. Seddon,et al.  THREE TYPES OF NERVE INJURY , 1943 .

[5]  W. B. Highet,et al.  TRACTION INJURIES TO THE LATERAL POPLITEAL NERVE AND TRACTION INJURIES TO PERIPHERAL NERVES AFTER SUTURE , 1943 .

[6]  F. K. Sanders,et al.  The effects of stretching nerves after suture , 1943 .

[7]  F. H. Lewey,et al.  Tensile strength of human nerves; an experimental physical and histologic study. , 1948, Archives of neurology and psychiatry.

[8]  R. Barnes.  Traction injuries of the brachial plexus in adults. , 1949, The Journal of bone and joint surgery. British volume.

[9]  D. Schneider,et al.  Die Dehnbarkeit der markhaltigen Nervenfaser des Frosches in Abhängigkeit von Funktion und Struktur , 1952 .

[10]  W. Holmes,et al.  Histopathology of nerve injury. , 1954, Special report series (Medical Research Council (Great Britain)).

[11]  I. Tarlov,et al.  Myelography to help localize traction lesions of the brachial plexus. , 1954, American journal of surgery.

[12]  T. I. Hoen,et al.  Peripheral nerve lengthening. I. Experimental. , 1956, Journal of neurosurgery.

[13]  G. Bonney,et al.  Prognosis in traction lesions of the brachial plexus. , 1959, The Journal of bone and joint surgery. British volume.

[14]  S. Sunderland,et al.  STRESS-STRAIN PHENOMENA IN HUMAN PERIPHERAL NERVE TRUNKS , 1961 .

[15]  S. Sunderland,et al.  STRESS-STRAIN PHENOMENA IN DENERVATED PERIPHERAL NERVE TRUNKS , 1961 .

[16]  S. Sunderland,et al.  STRESS-STRAIN PHENOMENA IN HUMAN SPINAL NERVE ROOTS , 1961 .

[17]  Thomas Pk,et al.  The connective tissue of peripheral nerve: an electron microscope study. , 1963 .

[18]  H. J. Gamble,et al.  AN ELECTRON MICROSCOPE STUDY OF THE CONNECTIVE TISSUES OF HUMAN PERIPHERAL NERVE. , 1964, Journal of anatomy.

[19]  R. Leffert,et al.  INFRACLAVICULAR BRACHIAL PLEXUS INJURIES. , 1965, The Journal of bone and joint surgery. British volume.

[20]  J Haftek,et al.  Electron-microscope observations on the effects of localized crush injuries on the connective tissues of peripheral nerve. , 1968, Journal of anatomy.

[21]  E. Vassalos,et al.  Brachial plexus paralysis in the newborn , 1968 .