Flores Leandro P, Koerbel Andrei, Tatagiba Marcos
Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany.
Surg Neurol. 2005 Sep;64(3):249-52; discussion 252. doi: 10.1016/j.surneu.2004.11.031.
The anatomical relationship of the fibular head with the fibular nerve is a critical point in regard to injuries of peripheral nerves in the lower extremities. In this location, the peroneal nerve may be injured due to several mechanisms, and osteophyte-like lesions can be considered as a differential diagnosis.
The suitable literature concerning this association is reviewed and a case is presented. A 15-year-old adolescent boy presented with right peroneal nerve palsy on admission. The radiological examinations (computed tomography and magnetic resonance imaging) demonstrated an osteophytic lesion in the head of the right fibula. The patient underwent surgical decompression of the nerve and resection of the lesion. Postoperatively, there was a complete recovery of the deficits.
The association of osteophyte-like bone changes and peroneal nerve palsy is rare. The differential diagnoses of these lesions include cartilaginous exostoses and osteochondromas, which may be related to hereditary multiple exostoses syndrome. The timing of the treatment plays an important role in the neurological recovery.
腓骨头与腓总神经的解剖关系是下肢周围神经损伤的一个关键点。在此部位，腓总神经可能因多种机制而受损，骨赘样病变可被视为一种鉴别诊断。
回顾了有关这种关联的合适文献并呈现了一个病例。一名15岁青少年男性入院时出现右侧腓总神经麻痹。影像学检查（计算机断层扫描和磁共振成像）显示右侧腓骨头有骨赘样病变。患者接受了神经减压手术和病变切除术。术后，缺损完全恢复。
骨赘样骨质改变与腓总神经麻痹的关联罕见。这些病变的鉴别诊断包括软骨外生骨疣和骨软骨瘤，它们可能与遗传性多发性外生骨疣综合征有关。治疗时机在神经恢复中起重要作用。
