肋间神经切除术治疗症状性肋骨骨折不愈合后出现的腹部侧腹膨出。
Abdominal flank bulge following intercostal neurectomy for symptomatic rib fracture nonunion.
机构信息
Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, Zuid-Holland, The Netherlands
Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, Zuid-Holland, The Netherlands.
出版信息
BMJ Case Rep. 2021 Jun 11;14(6):e242041. doi: 10.1136/bcr-2021-242041.
The gold standard for rib fracture nonunion management remains a matter of debate. Operative treatment of rib fracture nonunion has become increasingly popular. A 69-year-old man was operatively treated with intercostal neurectomy of the left eighth rib to resolve chronic thoracic pain following a rib fracture nonunion. After the intervention, the patient developed a flank bulge which was most likely due to the intercostal neurectomy, causing partial denervation of the abdominal musculature. Although the pain at the nonunion site decreased after the operative intervention, the patient still experienced severe pain during daily activities and reported poor quality of life due to the flank bulge. Physiotherapy and an abdominal belt did not improve this flank bulge. When considering operative neurectomy of the intercostal nerves of ribs 7-12 to resolve chronic pain due to rib fracture nonunion, the treating surgeon should be aware of this debilitating complication.
肋骨骨折不愈合的金标准治疗仍存在争议。手术治疗肋骨骨折不愈合已越来越受欢迎。一位 69 岁男性因肋骨骨折不愈合后慢性胸痛而行左侧第八肋骨肋间神经切断术。干预后，患者出现侧腹膨隆，很可能是肋间神经切断术引起的，导致部分腹部肌肉去神经支配。虽然手术干预后骨折不愈合部位的疼痛减轻，但患者在日常活动中仍感到剧烈疼痛，由于侧腹膨隆，生活质量较差。物理治疗和腹带并不能改善这种侧腹膨隆。当考虑手术切除第 7-12 肋骨的肋间神经以解决因肋骨骨折不愈合引起的慢性疼痛时，治疗医生应该意识到这种使人虚弱的并发症。
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