Department of Orthopedic Surgery, Cincinnati Children's Hospital, Cincinnati, Ohio.
Department of Orthopedic Surgery, Walter-Reed Military Medical Center, Bethesda, Maryland.
JBJS Case Connect. 2024 Oct 11;14(4). doi: e24.00277. eCollection 2024 Oct 1.
We report 2 cases of common peroneal nerve (CPN) palsy after inside-out lateral meniscus (LM) repair with very different presentations, occurring despite the standard surgical precautions (open counter incision and proper retraction between the biceps femoris tendon, lateral gastrocnemius, and capsule). On exploration, needle was found to have penetrated the nerve in one case and the nerve sheath in the other case. Patient 1 had near-complete neurological recovery, while patient 2 had partial neurological recovery after suture removal and neurolysis.
CPN palsy can occur despite following all precautions during LM repair and should be managed as an iatrogenic injury unless proven otherwise.
我们报告了 2 例外侧半月板（LM）内缝合修复术后常见腓总神经（CPN）麻痹的病例，其表现截然不同，尽管采用了标准的手术预防措施（开放对抗切口和股二头肌肌腱、外侧腓肠肌和囊之间的适当牵引）。在探查时，发现一例针穿过神经，另一例穿过神经鞘。1 例患者几乎完全恢复神经功能，2 例患者在缝线取出和神经松解后部分恢复神经功能。
尽管在 LM 修复过程中遵循了所有预防措施，但仍可能发生 CPN 麻痹，除非另有证据，否则应将其视为医源性损伤进行处理。
