Kim Katherine J, Cuturrufo Isabella V, Vitale Kenneth
Department of Orthopedic Surgery, Division of Sports Medicine, University of California San Diego School of Medicine, La Jolla, USA.
Cureus. 2024 Nov 25;16(11):e74420. doi: 10.7759/cureus.74420. eCollection 2024 Nov.
Achilles tendon ruptures are prevalent among physically active adults and can lead to sural nerve injuries (SNIs) due to the anatomical proximity of the sural nerve to the Achilles tendon. While SNIs are well-recognized in surgical contexts, their occurrence following nonoperative treatments, which are often preferred for their lower risk of surgical complications, remains less documented and poorly understood. This report describes a case of a 30-year-old active male who developed chronic traction sural neuropathy after opting for nonoperative treatment of an acute complete Achilles tendon rupture. Despite adhering to a rehabilitation protocol, he experienced persistent symptoms of sural nerve damage, which were confirmed as chronic sensory neuropathy through nerve conduction studies. Here, we discuss the proposed pathophysiology and review the literature on SNIs in Achilles injuries. This case highlights the importance for clinicians to accurately diagnose and remain aware of the potential for SNIs in the nonoperative management of Achilles tendon ruptures.
跟腱断裂在身体活跃的成年人中很常见，由于腓肠神经与跟腱在解剖位置上相近，可能导致腓肠神经损伤（SNIs）。虽然在手术情况下，腓肠神经损伤已广为人知，但在非手术治疗后其发生情况记录较少且了解不足，而由于手术并发症风险较低，非手术治疗通常更受青睐。本报告描述了一名30岁活跃男性的病例，该男性在选择对急性完全性跟腱断裂进行非手术治疗后，出现了慢性牵引性腓肠神经病变。尽管遵循了康复方案，但他仍有持续的腓肠神经损伤症状，通过神经传导研究证实为慢性感觉神经病变。在此，我们讨论所提出的病理生理学，并回顾关于跟腱损伤中腓肠神经损伤的文献。该病例强调了临床医生在跟腱断裂非手术治疗中准确诊断并意识到腓肠神经损伤可能性的重要性。
