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高位胫骨截骨术后腓总神经功能障碍的长期影响:术前及术后电生理研究

Prolonged peroneal nerve dysfunction after high tibial osteotomy: pre- and postoperative electrophysiological study.

作者信息

Aydogdu S, Cullu E, Araç N, Varolgüneş N, Sur H

机构信息

Department of Orthopedics and Traumatology, Ege University, Faculty of Medicine, Izmir, Turkey.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2000;8(5):305-8. doi: 10.1007/s001670000138.

Abstract

To evaluate electrophysiological incidence and the type of peroneal nerve lesions seen after high tibial osteotomy we conducted an electrophysiological study (electromyography and nerve conduction velocity studies) in 11 patients who were suffering from medial gonarthrosis and treated by Maquet barrel-vault type high tibial valgization osteotomy. All the patients were tested both pre- and postoperatively. Every patient was examined postoperatively for a minimum of a 6 months after surgery to eliminate spontaneously reversible lesions. Results obtained from nonoperated legs served as controls. Three patients (27%) with peroneal nerve lesions were detected electrophysiologically; one had only motor involvement, one only sensory involvement, and one both motor and sensory involvement. Clinically only one of these patients was symptomatic, and the other two were detected by electrophysiological means. Peroneal nerve lesions which may be overlooked by mild weakness and hypesthesia in the early postoperative period can be detected by electrophysiological means at a higher rate than expected. These lesions persist a relatively long time and even can be permanent despite the absence of clinical symptoms.

摘要

为了评估高位胫骨截骨术后腓总神经损伤的电生理发生率及类型,我们对11例患有内侧膝关节病并接受Maquet桶状外翻型高位胫骨截骨术治疗的患者进行了一项电生理研究(肌电图和神经传导速度研究)。所有患者均在术前和术后进行了检测。每位患者术后至少接受6个月的检查,以排除自发可逆性损伤。取自未手术侧下肢的结果用作对照。通过电生理检测发现3例(27%)患者存在腓总神经损伤;1例仅有运动功能受累,1例仅有感觉功能受累,1例运动和感觉功能均受累。临床上这些患者中只有1例有症状,另外2例通过电生理手段检测出。术后早期可能被轻微无力和感觉减退所忽视的腓总神经损伤,通过电生理手段检测出的发生率高于预期。这些损伤会持续较长时间,即使没有临床症状甚至也可能是永久性的。

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