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创伤性骨化性肌炎导致的坐骨神经迟发性损伤

Delayed Sciatic Nerve Injury Resulting From Myositis Ossificans Traumatica.

作者信息

Guan Zhe, Wilson Thomas J, Jacobson Jon A, Hollon Todd C, Yang Lynda J-S

机构信息

University of Michigan Medical School, University of Michigan, Ann Arbor, MI(∗).

Department of Neurosurgery, University of Michigan, Ann Arbor, MI(†).

出版信息

PM R. 2016 May;8(5):484-7. doi: 10.1016/j.pmrj.2015.10.011. Epub 2015 Nov 5.

Abstract

A motorcyclist sustained multiple-system trauma, including a left buttock hematoma requiring decompression and evacuation. Presentation for severe hip pain and lower extremity weakness was delayed. Imaging revealed myositis ossificans traumatica compressing the sciatic nerve in the buttock. The patient underwent sciatic nerve decompression with resection of heterotopic calcification, resulting in improvement in pain and left lower extremity function. This case illustrates the contrast in differential diagnosis of peripheral nerve injury immediately posttrauma and that occurring in a slow, delayed fashion posttrauma. Myositis ossificans may be an underrecognized complication of trauma but should be considered in cases of delayed peripheral nerve injury after trauma.

摘要

一名摩托车手遭受了多系统创伤,包括左侧臀部血肿,需要进行减压和引流。因严重髋部疼痛和下肢无力而就诊的时间有所延迟。影像学检查显示创伤性骨化性肌炎压迫臀部坐骨神经。患者接受了坐骨神经减压术并切除异位钙化组织,疼痛和左下肢功能得到改善。该病例说明了创伤后立即发生的周围神经损伤与创伤后缓慢、延迟发生的周围神经损伤在鉴别诊断上的差异。创伤性骨化性肌炎可能是一种未被充分认识的创伤并发症,但在创伤后延迟性周围神经损伤的病例中应予以考虑。

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