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儿童正中神经连续性创伤性神经瘤:一例报告

Post Traumatic Neuroma in Continuity of the Median Nerve in a Child: A Case Report.

作者信息

Giannatos Vasileios, Ierodiakonou Sosanna, Koutas Konstantinos, Argyropoulou Evangelia, Tsoumpos Pantelis, Kokkalis Zinon

机构信息

Orthopedics and Traumatology, General University Hospital of Patras, Rio, GRC.

Orthopaedics and Traumatology, General University Hospital of Patras, Rio, GRC.

出版信息

Cureus. 2023 May 4;15(5):e38537. doi: 10.7759/cureus.38537. eCollection 2023 May.

Abstract

An 8-year-old girl suffered a wrist laceration from a sharp glass, severing the median nerve. The nerve was end-to-end repaired at the time by a pediatric orthopedic surgeon. Six months later, the girl suffered wrist pain and hyperesthesia over the previous surgical incision, significantly affecting her daily activities. Physical examination revealed a palpable mass over the median nerve with a positive Tinel sign, and the diagnosis of a painful neuroma in continuity was set. She underwent another surgery where the defective neuroma in-continuity was excised, and the median nerve was reconstructed using sural nerve cable autografts. At 18 months follow-up after the second surgery, the girl appeared with a full passive and active painless range of motion and a negative Tinel sign. This is the first case of neuroma in continuity presenting in a child in the literature, successfully managed surgically.

摘要

一名8岁女孩因被尖锐玻璃割伤手腕,致使正中神经断裂。当时由一名小儿骨科外科医生进行了端端神经修复手术。6个月后,女孩出现手腕疼痛以及手术切口部位感觉过敏,严重影响了她的日常活动。体格检查发现正中神经处可触及肿块,Tinel征阳性,诊断为连续性疼痛性神经瘤。她接受了另一次手术,切除了连续性有缺陷的神经瘤,并使用腓肠神经电缆自体移植对正中神经进行了重建。在第二次手术后18个月的随访中,女孩的腕关节被动和主动活动范围完全无痛,Tinel征阴性。这是文献中首例报道的儿童连续性神经瘤病例,并通过手术成功治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5755/10239210/1346a6138f1c/cureus-0015-00000038537-i01.jpg

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