Wu Katie Pei-Hsuan, Lin Li-Ching, Lu Johnny Chuieng-Yi
Department of Physical Medicine and Rehabilitation, Chang Gung Medical University, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan.
Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Medical University, Chang Gung Memorial Hospital, Linkou, Taiwan.
Arch Plast Surg. 2022 Dec 13;49(6):769-772. doi: 10.1055/s-0042-1756290. eCollection 2022 Nov.
Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.
股神经损伤是一种严重的损伤，可导致股四头肌麻痹，削弱膝关节伸展功能，从而妨碍行走。我们报告了一例因电击伤导致的严重股神经病变病例，在该病例中无法确定明显的神经断裂部位，因此无法采用传统的神经重建方法，如神经修复、移植或转位。同时发生的脊髓损伤导致拮抗肌痉挛性肌病，进一步限制了膝关节伸展。我们的策略是：（1）采用增压端侧技术（SETS）增强目标肌肉的功能；（2）进行部分肌腱延长以松解痉挛肌肉。术后被动和主动活动范围显著改善，突出了该策略治疗部分股神经损伤的有效性。
