Hopton B P, Tommichan M C, Howell F R
Department of Orthopaedic Surgery, Hull Royal Infirmary, Hull, UK.
Knee. 2004 Aug;11(4):289-91. doi: 10.1016/j.knee.2003.09.004.
One hundred and thirteen knees were assessed for lateral skin flap numbness, 5-227 weeks following IB2 total knee arthroplasty. The final 53 had the numb area measured. To define the anatomy of the cutaneous nerves we dissected four cadaveric knees. Eighty-six percent of patients had a numb area on objective assessment but only 60% had subjective numbness, 62% of which had improved. Patients had a larger numb area if they were aware of a numb patch, had a scar over 22 cm long or were less than 25 weeks following surgery. We conclude that not all patients will get lateral skin flap numbness and improvement occurs with time. The area of numbness can be reduced by using a shorter proximal incision, which preserves branches of the medial and intermediate cutaneous nerves of thigh.
在进行IB2全膝关节置换术后5至227周,对113个膝关节进行了外侧皮瓣麻木情况评估。最后对其中53个膝关节的麻木区域进行了测量。为明确皮神经的解剖结构,我们解剖了4个尸体膝关节。客观评估显示86%的患者存在麻木区域,但主观感觉麻木的患者仅占60%,其中62%的患者麻木情况有所改善。若患者意识到有麻木斑块、瘢痕长度超过22厘米或术后不满25周,则其麻木区域更大。我们得出结论,并非所有患者都会出现外侧皮瓣麻木,且麻木情况会随时间改善。采用较短的近端切口可减少麻木区域,该切口能保留股内侧皮神经和股中间皮神经的分支。