Mens Raf, van Houten Albert, Brokelman Roy Bernardus Gerardus, Hoogeslag Roy
Orthopedisch Centrum Oost Nederland, Hengelo, The Netherlands.
Orthopedisch Centrum Oost Nederland, Hengelo, The Netherlands
BMJ Case Rep. 2021 Apr 13;14(4):e240736. doi: 10.1136/bcr-2020-240736.
We present a case of iatrogenic injury to the common peroneal nerve (CPN) occurring due to harvesting of a hamstring graft, using a posterior mini-incision technique. A twitch of the foot was noted on retraction of the tendon stripper. After clinically diagnosing a CPN palsy proximal to the knee, the patient was referred to a neurosurgeon within 24 hours. An electromyography (EMG) was not obtained since it cannot accurately differentiate between partial and complete nerve injury in the first week after injury. Because the nerve might have been transacted by the tendon stripper, surgical exploration within 72 hours after injury was indicated. An intraneural haematoma was found and neurolysis was performed to decompress the nerve. Functioning of the anterior cruciate ligament was satisfactory during follow-up. Complete return of motor function of the CPN was observed at 1-year follow-up, with some remaining hypoaesthesia.
我们报告一例因采用后外侧小切口技术取腘绳肌移植物而导致的医源性腓总神经（CPN）损伤病例。在牵拉肌腱剥离器时发现足部有抽搐。在临床诊断为膝关节近端CPN麻痹后，患者在24小时内被转诊至神经外科医生处。由于在损伤后的第一周，肌电图（EMG）无法准确区分部分神经损伤和完全神经损伤，因此未进行此项检查。鉴于神经可能已被肌腱剥离器切断，故建议在损伤后72小时内进行手术探查。术中发现神经内血肿，并进行了神经松解以减压神经。随访期间前交叉韧带功能良好。在1年随访时观察到CPN运动功能完全恢复，但仍有一些感觉减退。
