Department of Orthopaedic Surgery, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
Knee Surg Sports Traumatol Arthrosc. 2010 Jun;18(6):794-6. doi: 10.1007/s00167-009-0980-0. Epub 2009 Nov 14.
Arthroscopically assisted anterior cruciate ligament reconstruction is regarded as a minimally invasive surgery with low morbidity but complications still occur. Reports of neurovascular injuries related to graft harvesting, tunnel placement, or graft fixation are limited. A rare case of peroneal nerve injury related to hardware used for graft fixation in the tibial in a 28-year-old female patient who underwent an anterior cruciate ligament reconstruction surgery using a patellar tendon graft (bone-tendon-bone graft) is presented. Post-operatively, the patient presented with clinical signs of peroneal nerve damage and a reduced range of motion of the knee. Plain radiographs of the knee showed the bicortical screw which used for tibial fixation of the graft, penetrating the fibula and projecting beyond the lateral cortex of the fibular neck. The patient was treated with removal of the hardware and the graft. Intensive physiotherapy resulted in gradual improvement and at 6 months after the second operation the patient regained full range of motion of the knee and almost full muscle strength performing her daily activities without any difficulty and she is at the moment unwilling to undergo further procedure.
关节镜辅助前交叉韧带重建被认为是一种微创手术，发病率低，但仍会发生并发症。与移植物采集、隧道放置或移植物固定相关的神经血管损伤的报告有限。本文报道了 1 例罕见的与胫骨中用于固定移植物的硬件相关的腓总神经损伤病例，该患者为 28 岁女性，接受了髌腱移植物（骨-腱-骨移植物）前交叉韧带重建手术。术后，患者出现腓总神经损伤的临床症状和膝关节活动度降低。膝关节的 X 线平片显示，用于胫骨固定移植物的皮质双螺钉穿透腓骨并突出于腓骨颈的外侧皮质。患者接受了去除硬件和移植物的治疗。强化物理治疗导致逐渐改善，在第二次手术后 6 个月，患者恢复了膝关节的完全活动度，几乎完全恢复了股四头肌力量，能够进行日常活动而没有任何困难，目前她不愿意再进行进一步的手术。
