Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Clin J Sport Med. 2019 Jul;29(4):281-284. doi: 10.1097/JSM.0000000000000514.
The goal of this study was to characterize the risk of intraoperative injury to the posterior femoral cutaneous nerve and to evaluate potential risk factors for injury during surgical repair of proximal hamstring injuries.
Retrospective cohort study.
Single tertiary referral center.
The cohort consisted of all patients presenting to a single institution with a proximal hamstring avulsion injury who were managed with surgical repair between January 1, 2000 and August 1, 2016. A total of 67 patients were included in the cohort.
Variables assessed for their association with postoperative numbness in the distribution of the posterior femoral cutaneous nerve included age, sex, body mass index, mechanism of injury, time to surgical repair, and incision used.
The primary outcome of interest was neurologic symptoms referable to the posterior femoral cutaneous nerve.
Postoperatively, 13 patients (19%) developed new numbness in the distribution of the posterior femoral cutaneous nerve. One patient reported neuropathic pain and paresthesias associated with the numbness. The use of a gluteal crease incision was the only predictive factor for postoperative numbness in the posterior femoral cutaneous nerve distribution (odds ratio 8.67; 95% confidence interval, 2.30-42.80; P = 0.001).
The current study provides data that can be used in discussing the risks and benefits of surgical repair with patients and when weighing the pros and cons of using a gluteal crease versus longitudinal incision.
本研究旨在描述术中损伤股后皮神经的风险，并评估在修复近端腘绳肌损伤时发生损伤的潜在危险因素。
回顾性队列研究。
单中心三级转诊机构。
本队列纳入了 2000 年 1 月 1 日至 2016 年 8 月 1 日期间因近端腘绳肌撕脱伤就诊于单一机构并接受手术修复的所有患者。共有 67 例患者纳入本队列。
评估与股后皮神经分布区术后麻木相关的变量包括年龄、性别、体重指数、损伤机制、手术修复时间和切口类型。
主要研究结局为股后皮神经相关的神经症状。
术后 13 例（19%）患者出现股后皮神经分布区新的麻木感。1 例患者报告麻木伴神经病理性疼痛和感觉异常。股后皮神经分布区术后麻木的唯一预测因素是使用臀沟切口（比值比 8.67；95%置信区间，2.30-42.80；P=0.001）。
本研究提供了可用于与患者讨论手术修复风险和获益的数据，以及权衡使用臀沟切口与纵行切口的利弊。
