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The overall success rate of motor recovery after end-to-side nerve suture was 43.5%.
Battiston et al. reported eleven patients that underwent various end-to-side nerve repairs, almost always in order to support shoulder function in abduction and external rotation movements.
Recently, Yüksel et al. reported satisfactory results in a patient who had side-to-side nerve neurorrhaphy between the ulnar and median nerves [ 19].
Subsequently, Viterbo et al. investigated nerve regeneration after end-to-side nerve suture with and without perineural window reporting similar results [ 9].
The concept of end-to-side nerve suture has also been applied to the prevention and treatment of painful neuromas secondary to damage of sensory nerves.
Moreover, Dvali and Myckatyn [ 3] have reviewed the literature on end-to-side nerve repair and concluded that although this technique results in some nerve regeneration, the regeneration is not robust.
A rat model investigated such configuration of end-to-side nerve suture and showed that axonal regeneration through interpositional was bidirectional and preferentially directed towards the injured side clarifying the basis of clinical application [ 39].
In his comprehensive study on the use of end-to-side nerve suture in clinical practice, Mennen described five cases of palmar digital nerves terminolateral neurorrhaphy reporting four good results based on the Highet British Medical Research Council test [ 16].
The concept of reverse end-to-side nerve suture with axonal supercharging of the recipient nerve has been also experimentally investigated in rat model with complete and incomplete sciatic nerve injuries.
Other experimental studies suggested that the ingrowth of regenerating axons is significantly enhanced by breaching the epiperineural sheath at the coaptation site [ 10] and that an epineural window followed by terminolateral suture without damage of underlying perineurium improves functional outcomes of end-to-side nerve suture [ 1].
In our personal experience we reported sensory recovery in seven patients with end-to-side nerve suture of collateral digital nerves observing S3+ recovery in six cases and S3 in one case with a mean 2pd of 12.5 mm (range 8 18 mm) [ 19].
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