Fabre T, Montero C, Gaujard E, Gervais-Dellion F, Durandeau A
Groupe Hospitalier Pellegrin, Bordeaux, France.
Am J Sports Med. 2000 Sep-Oct;28(5):679-82. doi: 10.1177/03635465000280051001.
We retrospectively analyzed the charts of 13 athletes (18 limbs) who had sural nerve entrapment localized in the passage of the nerve through the superficial sural aponeurosis. There were 11 men and 2 women (average age, 43 years; range, 31 to 59). All patients reported chronic calf pain that was exacerbated during physical exertion. Delay to diagnosis averaged 9 months (range, 5 to 24). Tenderness in the calf was identified along the course of the sural nerve in all cases. In 10 patients (15 limbs) electrodiagnostic testing before surgery was positive. After failure of nonoperative treatment, surgery was conducted under local anesthesia. Neurolysis was performed by incising the superficial sural aponeurosis and the fibrous band in it through which the nerve passes. The results of the operation were evaluated in terms of residual symptoms, ability to return to the former sport, and degree of patient satisfaction. A final follow-up examination was performed an average of 14 months (range, 6 to 30) after the operation. The final result was excellent in 9 limbs (2 bilateral), good in 8 limbs (2 bilateral), and fair in 1 case. The differential diagnosis of sural nerve entrapment in athletes is discussed. Increase in sural muscle mass or development of local fibrous scar tissue compromised the sural nerve in its course through the unyielding and inextensible superficial sural aponeurosis.
我们回顾性分析了13例运动员（18条肢体）的病历，这些运动员的腓肠神经在通过腓肠浅筋膜时发生卡压。其中男性11例，女性2例（平均年龄43岁；范围31至59岁）。所有患者均报告有慢性小腿疼痛，在体力活动时加重。诊断延迟平均为9个月（范围5至24个月）。所有病例在腓肠神经走行部位均发现小腿压痛。10例患者（15条肢体）术前电诊断测试呈阳性。非手术治疗失败后，在局部麻醉下进行手术。通过切开腓肠浅筋膜及其内神经穿过的纤维带进行神经松解术。根据残留症状、恢复原运动能力和患者满意度对手术结果进行评估。术后平均14个月（范围6至30个月）进行了最后一次随访检查。最终结果为9条肢体（2例双侧）优，8条肢体（2例双侧）良，1例一般。文中讨论了运动员腓肠神经卡压的鉴别诊断。腓肠肌质量增加或局部纤维瘢痕组织形成会在腓肠神经穿过坚韧且不可伸展的腓肠浅筋膜过程中对其造成压迫。
