Gulhane Military Medical Academy, Ankara, Turkey.
Neurol Neurochir Pol. 2011 Sep-Oct;45(5):461-6. doi: 10.1016/s0028-3843(14)60314-5.
We investigated the management outcome of common peroneal nerve decompression at the knee level between the years 2005 and 2009.
Thirty consecutive patients with knee-level peroneal nerve injury who underwent decompression surgery and external neurolysis at our institution were evaluated preoperatively and postoperatively by electrophysiological studies and motor examination (Medical Research Council grading).
Twenty-eight of the cases were male and 2 were female. Mean age was 31.1 for males and 57.5 for females. Physical activity during military training (overstretch/contusion) was the cause of nerve lesion in the majority of the patients (n = 28, 93%). Mean time interval between the diagnosis and the surgery was 5 months. Follow-up time ranged from 3 to 48 months (mean: 14 months). Twenty-nine of 30 (97%) patients recovered totally or near totally in foot/toe dorsiflexion.
Early decompression and neurolysis of the common peroneal nerve (CPN) at knee level after strenuous physical activity offers excellent functional recovery. Additionally, for knee-level CPN injuries, in order to minimize the postoperative scar, pain and delay in wound healing, we strictly advocate short 'lazy S-shaped incision' around the fibular head in supine position unlike the classical extensive opening up to the superior border of the popliteal fossa in prone position.
我们研究了 2005 年至 2009 年间膝关节水平腓总神经减压的治疗结果。
在我们的机构中，对 30 例膝关节水平腓总神经损伤患者进行了减压手术和外部神经松解术，术前和术后均通过电生理研究和运动检查（医学研究委员会分级）进行评估。
28 例为男性，2 例为女性。男性的平均年龄为 31.1 岁，女性为 57.5 岁。大多数患者（n=28，93%）的神经损伤是由于军事训练中的体力活动（过度伸展/挫伤）引起的。从诊断到手术的平均时间间隔为 5 个月。随访时间为 3 至 48 个月（平均 14 个月）。30 例中的 29 例（97%）在足/趾背屈方面完全或接近完全恢复。
剧烈体力活动后膝关节水平腓总神经（CPN）的早期减压和神经松解可提供极好的功能恢复。此外，对于膝关节水平的 CPN 损伤，为了最大限度地减少术后疤痕、疼痛和伤口愈合延迟，我们严格提倡在仰卧位下沿腓骨头进行短而“懒散的 S 形切口”，而不是经典的俯卧位下向上延伸至腘窝上缘的广泛切口。
