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预防医源性足下垂：膝关节损伤文献综述

Preventable iatrogenic cause of foot-drop in knee injuries with literature review.

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India.

出版信息

Chin J Traumatol. 2022 Jul;25(4):224-231. doi: 10.1016/j.cjtee.2021.06.005. Epub 2021 Jul 14.

DOI:10.1016/j.cjtee.2021.06.005
PMID:34330596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9252936/
Abstract

PURPOSE

Common peroneal nerve palsy is quite disabling and every effort should be made to prevent its injury during the treatment.

METHODS

We retrospectively reviewed the prospectively collected data of 7 cases of tibial plateau fractures in association with proximal fibula fracture from January 2019 to September 2019 who presented to emergency room of our hospital.

RESULTS

In addition to fibular neck fracture, the first case had type 6 tibial plateau displaced fracture and the second case had displaced acetabular fracture with instability of knee with tibial tuberosity avulsion. common peroneal nerve palsy developed following application of distal tibial skeletal traction in both the cases. Other 6 such cases remained neurologically intact as traction was not applied to them.

CONCLUSION

Such iatrogenic complication could have been prevented if the injury pattern of "concomitant medial and lateral columns" of the proximal leg is kept in mind by the treating surgeon before applying skeletal traction.

摘要

目的

腓总神经麻痹较为致残，在治疗过程中应尽力防止其损伤。

方法

我们回顾性分析了 2019 年 1 月至 9 月因胫骨平台骨折合并腓骨近端骨折而到我院急诊就诊的 7 例患者的前瞻性收集数据。

结果

除腓骨颈骨折外，第 1 例患者为 6 型胫骨平台移位骨折，第 2 例患者为髋臼骨折伴膝关节不稳定，合并胫骨结节撕脱。这两例患者均在应用胫骨远端骨牵引后出现腓总神经麻痹。另外 6 例患者由于未对其进行牵引，神经功能保持完整。

结论

如果治疗医生在应用骨牵引前牢记近端下肢“内外柱同时损伤”的损伤模式，这种医源性并发症是可以预防的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/a0bf89c67d41/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/e68a20b2364f/gr1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/c930a16d3bef/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/586ddcdea864/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/df9b1a1126f2/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/100cd7492a48/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/dab249c0b2d0/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/a0bf89c67d41/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/e68a20b2364f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/df4759f3529c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/97674bccbf97/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/c930a16d3bef/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/586ddcdea864/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/df9b1a1126f2/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/100cd7492a48/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/dab249c0b2d0/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9855/9252936/a0bf89c67d41/gr9.jpg

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本文引用的文献

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Orthop Surg. 2019 Feb;11(1):97-101. doi: 10.1111/os.12424. Epub 2019 Feb 8.
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Knee Injury Associated With Acetabular Fractures: A Multicenter Study of 1273 Patients.与髋臼骨折相关的膝关节损伤：一项对1273例患者的多中心研究。
J Orthop Trauma. 2016 Jan;30(1):48-51. doi: 10.1097/BOT.0000000000000425.
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Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation.
膝关节脱位后腓总神经与胫神经联合损伤：一种损伤还是两种？MRI与临床的相关性
Neurosurg Focus. 2015 Sep;39(3):E8. doi: 10.3171/2015.6.FOCUS15125.
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J Am Acad Orthop Surg. 2013 Jun;21(6):343-54. doi: 10.5435/JAAOS-21-06-343.
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