Bischoff J, Kortmann K-B, Engelhardt M
Klinik für Orthopädie, Unfall- und Handchirurgie, Klinikum Osnabrück, Am Finkenhügel 1, Osnabrück.
Z Orthop Unfall. 2010 Sep;148(5):589-93. doi: 10.1055/s-0029-1186106. Epub 2010 Apr 13.
This is a report of a 70-year-old patient with spontaneous pain of the dorsum area of the left foot. A few days later there was a sudden onset of foot drop. First, an idiopathic peroneal palsy was assessed but an MRI showed a cystic tumour near the fibular head. These findings resulted in the patient attending our clinic for surgical treatment. During the operation we found an intraneural ganglion of the deep peroneal nerve and the common peroneal nerve. There was no connection with the superior tibiofibular joint. The ganglion was therefore removed. Two months after the operation the patient reported an improvement of the pain but no improvement of movement of the foot. An intraneural ganglion of the peroneal nerve derives from the superior tibiofibular joint. Given access to the articular branch, the cyst typically spreads out proximally from the deep peroneal nerve to the common peroneal nerve and to the point of the sciatic nerve. The clinical symptoms are correlated with the extent of cyst propagation. Recommended therapy would include the ligation of the aricular branch, or synovectomy, or resection of the superior tibiofibular joint and decompression of the cyst.
这是一份关于一名70岁患者的报告,该患者左足背区域出现自发性疼痛。几天后突然发生足下垂。起初,评估为特发性腓总神经麻痹,但磁共振成像(MRI)显示腓骨头附近有一个囊性肿瘤。这些检查结果导致患者前来我们诊所接受手术治疗。手术中我们发现了腓深神经和腓总神经的神经内神经节。它与胫腓上关节没有连接。因此,将神经节切除。术后两个月,患者报告疼痛有所改善,但足部运动没有改善。腓总神经的神经内神经节起源于胫腓上关节。若有通向关节支的通道,囊肿通常从腓深神经向近端扩展至腓总神经,并延伸至坐骨神经部位。临床症状与囊肿扩展程度相关。推荐的治疗方法包括结扎关节支、滑膜切除术、切除胫腓上关节以及囊肿减压。