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将神经直接缝合并将膝关节固定于90°屈曲位作为治疗复杂膝关节创伤中腓总神经、胫神经和腓肠神经损伤的一种技术。

Direct nerve suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural nerve injuries in complex knee trauma.

作者信息

Döring Robert, Ciritsis Bernhard, Giesen Thomas, Simmen Hans-Peter, Giovanoli Pietro

机构信息

Department of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland

Department of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland.

出版信息

J Surg Case Rep. 2012 Dec 11;2012(12):rjs019. doi: 10.1093/jscr/rjs019.

DOI:10.1093/jscr/rjs019
PMID:24968417
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3854785/
Abstract

There are different ways to treat peripheral nerve injuries with concomitant defects in the lower extremity. One option is a direct nerve suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic nerve and its terminal branches as well as isolated nerve lesions. We used this technique to treat a case of multiple nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.

摘要

治疗下肢伴有缺损的周围神经损伤有不同的方法。一种选择是直接进行神经缝合，随后将膝关节固定于屈曲位，正如针对导致坐骨神经及其终末分支损伤的枪伤以及孤立性神经损伤所描述的那样。我们采用这种技术治疗了一例下肢多发性神经损伤合并复杂膝关节创伤的病例，该创伤包括双骨及后关节囊损伤。据我们所知，文献中尚未有针对这种合并伤的此项技术的描述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/c00c81b6e2c2/rjs01904.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/b09ff66db5b6/rjs01901.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/d847e414ef62/rjs01902.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/fa4c0af67b29/rjs01903.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/c00c81b6e2c2/rjs01904.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/b09ff66db5b6/rjs01901.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/d847e414ef62/rjs01902.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/fa4c0af67b29/rjs01903.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/3854785/c00c81b6e2c2/rjs01904.jpg

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1
Direct nerve suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural nerve injuries in complex knee trauma.将神经直接缝合并将膝关节固定于90°屈曲位作为治疗复杂膝关节创伤中腓总神经、胫神经和腓肠神经损伤的一种技术。
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引用本文的文献

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Defects of the sciatic nerve and its divisions treated by direct suturing in 90 degrees knee flexion: report on the first clinical series.在膝关节屈曲90度时通过直接缝合治疗坐骨神经及其分支缺损：首个临床系列报告
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2
Use of ultrasound and targeted physiotherapy to manage nerve sutures placed under joint flexion: a case series.使用超声和靶向物理疗法管理关节弯曲下放置的神经缝线：病例系列。
Acta Neurochir (Wien). 2022 May;164(5):1329-1336. doi: 10.1007/s00701-022-05195-w. Epub 2022 Apr 4.

本文引用的文献

1
Comparisons of outcomes from repair of median nerve and ulnar nerve defect with nerve graft and tubulization: a meta-analysis.神经移植与套管修复正中神经和尺神经缺损的疗效比较：荟萃分析。
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Gunshot injuries to the nerves.神经枪伤
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Lower-extremity peripheral nerve injuries: a Louisiana State University Health Sciences Center literature review with comparison of the operative outcomes of 806 Louisiana State University Health Sciences Center sciatic, common peroneal, and tibial nerve lesions.
下肢周围神经损伤：路易斯安那州立大学健康科学中心文献回顾，比较了 806 例路易斯安那州立大学健康科学中心坐骨神经、腓总神经和胫神经病变的手术结果。
Neurosurgery. 2009 Oct;65(4 Suppl):A18-23. doi: 10.1227/01.NEU.0000339123.74649.BE.
4
Surgical therapy of peripheral nerve lesions: current status and new perspectives.周围神经损伤的外科治疗：现状与新展望
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Sciatic and peroneal nerve injuries.
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Ann Neurol. 2002 Jan;51(1):69-81. doi: 10.1002/ana.10054.
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[Suture of the sciatic nerve performed 15 months after its section. Result 2 years later. Value of repeated exploration].[坐骨神经切断术后15个月进行缝合。2年后的结果。再次探查的价值]
Ann Chir. 1966 Oct;20(19):1145-9.
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The interfascicular nerve-grafting of the median and ulnar nerves.正中神经与尺神经的束间神经移植术。
J Bone Joint Surg Am. 1972 Jun;54(4):727-50.