Rein Susanne, Fabian Tobias, Krishnan Kartik, Benesch Stefan, Schackert Gabriele, Zwipp Hans, Lindner Claudia, Weindel Stefan
Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
Neurosurgery. 2009 Mar;64(3):519-25; discussion 526. doi: 10.1227/01.NEU.0000338954.93385.E4.
Cutaneous afferent nerves contribute to joint proprioception. The aim of this study was to retrospectively analyze the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting in comparison to controls.
The proprioception of the ankle in 24 patients after sural nerve harvesting was investigated. The sural nerve was harvested bilaterally in Group 1 (n = 10), in the right leg in Group 2 (n = 6), and in the left leg in Group 3 (n = 8). The proprioception of the ankle was also tested in controls (Group 4, n = 24). The peroneal reaction time (PRT) was measured on a tilting platform. The position sense test was performed. Balance control was investigated with the Biodex Stability System (Biodex Medical Systems, Shirley, NY) at the stable Level 8 and unstable Level 2.
No significant differences among the groups were seen in the position sense test, the PRT, and all scores of the Biodex Stability System. The PRT showed significant differences in comparison to the contralateral leg for the peroneus brevis muscle in Group 1 (P = 0.005) and Group 4 (P = 0.001) as well as for the peroneus longus muscle in Group 3 (P = 0.036) and Group 4 (P = 0.001).
The proprioception of the ankle in patients after sural nerve harvesting is not reduced in comparison to controls. Significant differences of the PRT between the left and right legs are attributable to leg dominance in most cases and not to a loss of innervation. Harvesting of the sural nerve does not result in ankle instability.
皮肤传入神经有助于关节本体感觉。本研究的目的是回顾性分析与对照组相比，腓肠神经采集术后患者皮肤传入神经对踝关节本体感觉的影响。
对24例腓肠神经采集术后患者的踝关节本体感觉进行了研究。第1组（n = 10）双侧采集腓肠神经，第2组（n = 6）在右腿采集，第3组（n = 8）在左腿采集。还对对照组（第4组，n = 24）的踝关节本体感觉进行了测试。在倾斜平台上测量腓骨反应时间（PRT）。进行位置觉测试。使用Biodex稳定性系统（Biodex医疗系统公司，纽约州雪莉）在稳定的8级和不稳定的2级对平衡控制进行研究。
在位置觉测试、PRT以及Biodex稳定性系统的所有评分中，各组之间均未观察到显著差异。与对侧腿相比，第1组（P = 0.005）和第4组（P = 0.001）的短腓骨肌以及第3组（P = 0.036）和第4组（P = 0.001）的长腓骨肌的PRT显示出显著差异。
与对照组相比，腓肠神经采集术后患者的踝关节本体感觉没有降低。左右腿之间PRT的显著差异在大多数情况下归因于腿部优势，而非神经支配丧失。腓肠神经采集不会导致踝关节不稳定。
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