胫骨结节前外侧骨突切除术后神经瘤疼痛的部分去神经支配治疗：一例报告
Partial Denervation for Neuroma Pain after Knee Anterior Tibial Tuberosity Exostectomy: A Case Report.
作者信息
Ngbilo Cedric, Ouabo Eric Choudja, Jovanovic Biljana, Saithna Adnan, Gillain Laurent, Cottet Bertrand Sonnery
机构信息
Department of Orthopedic and Traumatology Surgery, CHUV, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Department of Orthopedic, Centre Orthopédique Santy, Groupe Ramsay-General Health, FIFA Medical Center of Excellence, Lyon, France.
出版信息
J Orthop Case Rep. 2019;9(4):10-13. doi: 10.13107/jocr.2019.v09.i04.1456.
INTRODUCTION
Neuromas of the infrapatellar branch of the saphenous nerve (IBSN) can occur after direct trauma or surgical approaches to the anterior aspect of the knee. The purpose of this case report is to highlight the clinical presentation, diagnosis, and successful surgical management.
CASE REPORT
A 20-year-old patient who had a history of recent anterior knee surgery at another institution presented with allodynia, dysesthesia, and a positive Tinel's test over the surgical scar. The pain was exacerbated by light touch, was progressively worse, and was limiting sports participation and activities of daily living. A clinical diagnosis of neuroma of the IBSN was made and this was successfully treated by microsurgical neurolysis, resection of the neuroma, and burying of the stump. This resulted in complete resolution of pain.
CONCLUSION
Neuromas of the IBSN can cause significant symptoms affecting activities of daily living. Microsurgical neurolysis is a useful treatment modality associated with complete resolution of pain and high patient satisfaction.
引言
隐神经髌下支（IBSN）神经瘤可发生于膝关节前部受到直接创伤或手术入路之后。本病例报告的目的是强调其临床表现、诊断及成功的手术治疗方法。
病例报告
一名20岁患者，近期在另一家机构接受了膝关节前部手术，现因手术瘢痕处出现异常性疼痛、感觉异常及Tinel征阳性前来就诊。轻触可使疼痛加剧，且逐渐加重，限制了其体育活动及日常生活。临床诊断为IBSN神经瘤，并通过显微外科神经松解术、神经瘤切除术及残端埋入术成功治疗。疼痛完全缓解。
结论
IBSN神经瘤可导致影响日常生活的显著症状。显微外科神经松解术是一种有效的治疗方式，可使疼痛完全缓解且患者满意度高。
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