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一名青少年因副比目鱼肌导致的胫神经外在压迫性神经病变。

Extrinsic compression neuropathy of the tibial nerve secondary to accessory soleus muscle in a young teenager.

作者信息

Badr Ismail Tawfeek, Hassan Soliman, Fotoh Dina Salem, Moawad Mahmoud Mohamed

机构信息

Orthopedic Department, Faculty of Medicine, Menoufia University, Egypt.

Rheumatology,physical Medicine and Rehabilitation Department, Faculty of Medicine, Menoufia University, Egypt.

出版信息

J Clin Orthop Trauma. 2020 Mar-Apr;11(2):302-306. doi: 10.1016/j.jcot.2019.12.008. Epub 2019 Dec 19.

Abstract

UNLABELLED

Compression neuropathy of the tibial nerve or one of its terminal branches (tarsal tunnel syndrome) is relatively uncommon. Accessory musculature on the posteromedial aspect of the ankle is a rare extrinsic cause of compression. Therefore, it should be considered in patients with prolonged manifestations of tibial nerve compression. A detailed history and physical examination, together with proper radiological evaluation, allow for accurate diagnosis. In this case report, a 13-year old female teenager on history, physical examination, and imaging studies was diagnosed as compression neuropathy of the tibial nerve secondary to accessory soleus muscle. After surgical excision of the accessory soleus muscle with no tarsal tunnel release, the patient presented with complete resolution of her manifestations continued free of symptoms for one and half year postoperatively. The accessory soleus muscle is a potential extrinsic cause for tibial nerve compression neuropathy.

LEVEL OF CLINICAL EVIDENCE

摘要

未标注

胫神经或其终末分支之一的压迫性神经病变(跗管综合征)相对少见。踝关节后内侧的副肌肉组织是一种罕见的外在压迫原因。因此,对于有胫神经压迫长期表现的患者应考虑这一因素。详细的病史和体格检查,以及适当的影像学评估,有助于准确诊断。在本病例报告中,一名13岁女性青少年经病史、体格检查和影像学研究,被诊断为比目鱼肌副肌继发的胫神经压迫性神经病变。在未松解跗管的情况下手术切除比目鱼肌副肌后,患者症状完全缓解,术后一年半持续无症状。比目鱼肌副肌是胫神经压迫性神经病变的一个潜在外在原因。

临床证据水平

5级。

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本文引用的文献

1
Tarsal Tunnel Syndrome Secondary to Accessory Musculature: A Case Report.继发于副肌肉组织的跗管综合征:一例报告
Foot Ankle Spec. 2019 Dec;12(6):549-554. doi: 10.1177/1938640019863277. Epub 2019 Aug 13.
2
Entrapment Neuropathies of the Lower Extremity.下肢嵌压性神经病。
Med Clin North Am. 2019 Mar;103(2):371-382. doi: 10.1016/j.mcna.2018.10.013. Epub 2018 Dec 3.
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