Ferraresi Stefano, Garozzo Debora, Buffatti Paolo
Department of Neurosurgery, Ospedale S Maria della Misericordia, Via Tre Martiri, 45100 Rovigo, Italy.
Neurosurg Rev. 2003 Jul;26(3):175-9. doi: 10.1007/s10143-002-0247-4. Epub 2003 Jan 14.
The authors report their experience in the treatment of common peroneal nerve (CPN) injuries using a one-stage procedure of nerve repair and tibialis posterior tendon transfer. A series of 45 patients with traumatic injury and graft repair of the CPN is presented. From 1988 to 1991, the six patients elected for surgery had only nerve repair: five ultimately did not recover, while muscle contraction in the remaining patient was graded M1-2. Since 1991, nerve surgery in our clinic was associated with tendon transfer procedures (39 cases) which were followed by a satisfactory reinnervation rate. Nerve transection and iatrogenic injuries, torsion/dislocation of the knee, complex biosseous fractures of the leg, and gunshot wounds showed excellent to fair results in decreasing order: in nerve sections, muscle recovery scored M3 or M4+ in all the patients, and in nerve ruptures due to severe dislocation of the knee, it was M3 or M4+ in 85% of cases. The association of microsurgical nerve repair and tendon transfer has changed the course of CPN injuries.
作者报告了他们使用神经修复和胫后肌腱转移一期手术治疗腓总神经(CPN)损伤的经验。本文介绍了一系列45例CPN创伤性损伤和移植修复的患者。1988年至1991年,选择手术的6例患者仅进行了神经修复:5例最终未恢复,而其余1例患者的肌肉收缩分级为M1-2。自1991年以来,我们诊所的神经手术与肌腱转移手术(39例)相关,术后再支配率令人满意。神经横断伤和医源性损伤、膝关节扭转/脱位、小腿复杂双骨骨折以及枪伤的治疗效果从优到良依次为:在神经横断伤中,所有患者的肌肉恢复评分为M3或M4+;在膝关节严重脱位导致的神经断裂中,85%的病例评分为M3或M4+。显微外科神经修复与肌腱转移相结合改变了CPN损伤的治疗进程。