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骨折相关的尺神经和坐骨神经横断伤:两例报告及文献综述

Fracture related ulnar and sciatic nerve transections: a report of two cases and literature review.

作者信息

Payne Russell A, Sieg Emily P, Patrick Nathan, Darowish Michael, Rizk Elias, Langan Sara, Harbaugh Kimberly

机构信息

Department of Neurosurgery, Penn State Milton S Hershey Medical Center, 30 Hope Drive; EC 110, Hershey, PA, 17033, USA.

Department of Orthopedic Surgery, Penn State Milton S Hershey Medical Center, Hershey, PA, USA.

出版信息

Childs Nerv Syst. 2018 Nov;34(11):2187-2194. doi: 10.1007/s00381-018-3961-0. Epub 2018 Sep 5.

Abstract

INTRODUCTION

Case reports, case series, and case control studies have looked at the incidence of complete nerve transection in the setting of fracture and the need for surgical exploration dating back to the 1920s. We present two cases of nerve laceration accompanying traumatic fracture with a thorough review of the literature.

METHODS

We used the following search terms: "ulnar nerve" OR "sciatic nerve" AND "laceration" OR "transection" AND "fracture." Results were reviewed and included for discussion if they specifically reported ulnar or sciatic nerve laceration accompanying traumatic fracture.

RESULTS

Our search yielded 15 papers reporting a total of 10 ulnar nerve lacerations and nine sciatic nerve lacerations. We present two additional cases. The first is a patient with a humerus fracture and complete ulnar nerve transection. The second case is a patient who suffered a femur fracture and complete transection of the sciatic nerve.

CONCLUSION

Nerve laceration accompanying traumatic fracture is rare. We review the reported cases of nerve laceration and present two cases treated at our institution. Though uncommon, nerve laceration should be considered in the setting of traumatic fracture with neurological injury, particularly open fractures.

摘要

引言

病例报告、病例系列研究和病例对照研究自20世纪20年代起就开始关注骨折情况下完全性神经横断的发生率以及手术探查的必要性。我们报告两例伴有创伤性骨折的神经撕裂伤病例,并对相关文献进行全面回顾。

方法

我们使用了以下检索词:“尺神经”或“坐骨神经”以及“撕裂伤”或“横断”以及“骨折”。对检索结果进行了审查,若具体报告了伴有创伤性骨折的尺神经或坐骨神经撕裂伤,则纳入讨论。

结果

我们的检索共得到15篇论文,报告了总计10例尺神经撕裂伤和9例坐骨神经撕裂伤。我们另外报告两例病例。第一例是一名肱骨骨折并伴有尺神经完全横断的患者。第二例是一名股骨骨折并伴有坐骨神经完全横断的患者。

结论

伴有创伤性骨折的神经撕裂伤较为罕见。我们回顾了已报告的神经撕裂伤病例,并介绍了在我们机构治疗的两例病例。尽管不常见,但在伴有神经损伤的创伤性骨折情况下,尤其是开放性骨折时,应考虑神经撕裂伤的可能性。

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