Igielska-Bela Barbara, Krzemiński Marek, Rzepecka-Wejs Ludomira
Department of Orthopedic, Specialist Hospital in Koscierzyna, Ul.Piechowskiego 36, 83-400 Kościerzyna, Poland.
Goris-Med Sp. p., Sopot, Poland.
J Orthop Case Rep. 2019;9(4):76-79. doi: 10.13107/jocr.2019.v09.i04.1488.
The intraneural ganglion cyst of the tibial nerve is very rare, especially at the level of an ankle and a foot. There are 15 previous reports of the tibial intraneural ganglion cyst within the tarsal tunnel or the popliteal fossa. The authors present an infrequent case of the tibial intraneural ganglion at the level of the tarsal tunnel diagnosed by an ultrasound examination and provide a review of the case studies described earlier in the available literature.
Patient, a 37-year-old Caucasian male, was admitted to the orthopedic outpatient clinic with the pain and the paresthesia of medial half of his right foot. He underwent an ultrasound examination which diagnosed the intraneural ganglion cyst of the tibial nerve. The patient was qualified for surgical treatment. The nerve was compressed to only 30% of its diameter. The nerve function returned in4 months post-operative and the patient presented no signs of the nerve disorder.
In almost all analyzed articles, authors suggest that pathogenesis is connected with the retrograde extension of the synovial fluid from the adjacent joints or with the trauma. In our study, there was no history of trauma and there was no connection with the joint during operation. We believed that the pathogenesis of this disorder was multifactorial.
胫神经内神经节囊肿非常罕见，尤其是在踝关节和足部水平。此前有15例关于跗管或腘窝内胫神经内神经节囊肿的报道。作者报告了1例通过超声检查诊断出的跗管水平胫神经内神经节囊肿罕见病例，并对现有文献中早期描述的病例研究进行了综述。
患者为一名37岁的白种男性，因右足内侧疼痛和感觉异常入住骨科门诊。他接受了超声检查，诊断为胫神经内神经节囊肿。该患者符合手术治疗条件。神经受压至其直径的仅30%。术后4个月神经功能恢复，患者未出现神经功能障碍迹象。
在几乎所有分析的文章中，作者认为发病机制与来自相邻关节的滑液逆行延伸或与创伤有关。在我们的研究中，没有创伤史，手术过程中也与关节无关联。我们认为这种疾病的发病机制是多因素的。
