Demonstration of three injection methods for the analysis of extrinsic and intrinsic blood supply of the peripheral nerve

Background The use of free vascularized nerve grafts requires an intimate and accurate knowledge of the blood supply of peripheral nerve. This study was designed to compare the advantages and disadvantages of three methods employed to reveal the blood supply of the peripheral nerve, and to provide morphological basis for vascularized nerve grafts. Methods The blood supply of brachial plexus and its main branches (ulnar, median, radial, musculocutaneous and axillary nerve) were observed using three vascular injection techniques: three specimens were injected with red latex through the thoracic aorta; two side specimens were injected with a Chinese ink solution, through the subclavian artery, for diaphanization and histology; one fresh cadaver was injected with the gelatin-lead oxide mixture through the femoral artery for radiography. Results The blood supply of the brachial plexus and its main branches was well examined using the three different-vascular injection techniques. Perfusion with red latex exposed the extrinsic blood supply. Diaphanization and histology showed the intrinsic blood supply, while gelatin lead oxide injection technique interactively displayed both the intrinsic and extrinsic blood supply to the peripheral nerve. Conclusion The standard method for the study of the extrinsic blood supply to the peripheral nerve is the red latex perfusion; diaphanization and histology are very suitable to study the intrinsic blood supply of the peripheral nerve; while gelatin-lead oxide technique is the standard for visualization of the integral topography of the blood supply of the peripheral nerve.