Histological Outcomes of
Rapid-stretch Nerve Injury

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Novel Histological Phenomena

Histological examination has revealed distinct patterns of injury to the internal architectural components of the nerve. Normal nerve fibers are arranged into oscillating undulations—stretch injury has demonstrated straightening of these fibers to an “elastic” threshold. Within the elastic threshold, fibers remain compliant and can recoil yet crossing this threshold into “in-elastic” territory is associated with permanent  length change due to straightening of fibers past compliancy. Finally, straightened fibers stretched past the inelastic threshold causes architectural disruption characterized by axons dehisced from their endoneurial tubules —-a phenomenon we have deemed “microrupture”. 

Reproducible Injury Grades Derived from Biomechanical Properties​

Histological quantification of microruptures has revealed regional variations in damage and a gradation of injury pattern. 

Future Directions

The permanent length change derived from the straightening of fibers, paired with microrupture damage once surpassing the inelastic threshold, underscores patterns of architectural injury specific to the rapid-stretch mechanism. Clinically, these injuries commonly develop the pathophysiological product of neuroma-in-continuity, yet it remains unclear as to what drives this pathological remodeling. As our histological results reveal unique patterns of damage with rapid-stretch injury, we hypothesize this severe damage underscores NIC development. 

Publication

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