Department of Orthopedic Surgery, Kurume University Medical Center, Kurume, Fukuoka, Japan.
Department of Orthopedic Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan.
JBJS Case Connect. 2021 Apr 9;11(2):01709767-202106000-00017. doi: e20.00670.
A 43-year-old man who underwent intramedullary nailing for a closed tibial fracture developed saphenous nerve entrapment neuropathy. He developed severe medial leg pain, which was worse on walking or standing, 2 years postoperatively. Surgical neurolysis resulted in complete pain relief and functional recovery of the limb without recurrence of symptoms.
Clinicians should consider several etiologies in the diagnostic evaluation of a patient with chronic pain after limb trauma. If a patient complains of lower extremity pain after intramedullary fixation of closed fractures of the tibial shaft, the possibility of saphenous nerve entrapment neuropathy should be considered.
一名 43 岁男子因闭合性胫骨骨折接受髓内钉固定后发生隐神经卡压性神经病。术后 2 年，他出现严重的小腿内侧疼痛，行走或站立时疼痛加剧。手术神经松解术使疼痛完全缓解，肢体功能恢复，无症状复发。
在创伤后肢体慢性疼痛的诊断评估中，临床医生应考虑多种病因。如果患者在胫骨骨干闭合性骨折髓内固定后抱怨下肢疼痛，则应考虑隐神经卡压性神经病的可能性。
