创伤性腓总神经损伤手术治疗后的临床结果：不同手术方式的危险因素分析

Clinical Outcome After Surgical Treatment of Traumatic Peroneal Nerve Injury: An Analysis of Risk Factors After Different Surgical Approaches.

作者信息

Werkmann Daniel N, Bäzner Ute M, Petkov Martin, Minzenmay Lena, Durner Gregor, Antoniadis Gregor, Wirtz Christian R, Pedro Maria T, Knoll Andreas, Pala Andrej

机构信息

Department of Neurosurgery, University of Ulm, BKH Günzburg, Lindenallee 2, 89312 Günzburg, Germany.

Peripheral Nerve Unit, Department of Neurosurgery, BKH Günzburg at Ulm University, Lindenallee 2, 89312 Günzburg, Germany.

出版信息

Neurol Int. 2025 Jan 13;17(1):7. doi: 10.3390/neurolint17010007.

DOI:10.3390/neurolint17010007

PMID:39852771

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11768056/

Abstract

BACKGROUND

This study aims to analyze potential risk factors that may influence the clinical outcomes following surgical treatment of traumatic peroneal nerve lesions.

METHODS

We conducted a retrospective analysis of patients with traumatic peroneal nerve injuries treated with decompression, split repair, or nerve grafting between 2010 and 2020. Motor function and potential risk factors were evaluated.

RESULTS

Out of 93 patients, 42 (45%) underwent decompression, 15 (16%) received split repair, and 36 (39%) required autologous nerve grafting. Up to one year after surgery, weakness of the anterior tibial muscle improved from a median of M0 to M3. After one year following nerve decompression, functional recovery was observed in 28 (65%) cases, in 9 (21%) cases after split repair, and in 7 (16%) cases following autologous nerve grafting. A defect greater than 8 cm was associated with significantly poorer improvement of extensor hallucis longus ( = 0.037, HR 0.109). We found no significant associations between age, diabetes mellitus, arterial hypertension, obesity, and postoperative outcomes.

CONCLUSIONS

According to the present data, a significant number of patients achieved functional improvement following surgical treatment, indicating that this procedure should be considered an important treatment option in selected cases.

摘要

背景

本研究旨在分析可能影响创伤性腓总神经损伤手术治疗临床结局的潜在风险因素。

方法

我们对2010年至2020年间接受减压、劈开修复或神经移植治疗的创伤性腓总神经损伤患者进行了回顾性分析。评估了运动功能和潜在风险因素。

结果

93例患者中，42例（45%）接受了减压治疗，15例（16%）接受了劈开修复，36例（39%）需要自体神经移植。术后长达一年，胫前肌肌力从中位数M0改善至M3。神经减压术后一年，28例（65%）观察到功能恢复，劈开修复后9例（21%），自体神经移植后7例（16%）。缺损大于8 cm与拇长伸肌改善明显较差相关（ = 0.037，HR 0.109）。我们发现年龄、糖尿病、动脉高血压、肥胖与术后结局之间无显著关联。