Jokela Timo, Löppönen Pekka
Department of Orthopedics and Traumatology, Seinäjoki Central Hospital, Seinäjoki, Finland.
Trauma Case Rep. 2025 Apr 15;57:101183. doi: 10.1016/j.tcr.2025.101183. eCollection 2025 May.
A 17-year old male athlete presented with right knee and lower extremity pain that was resistant to traditional physical therapy and pain management for almost two years. He had played ice hockey as a goalie since childhood but was unable to return to play because of the pain. He had to a history of several different injuries to the same knee and had several MRI scans and physician visits without any help. Pain was aggravated by physical activity especially when the knee was extended but there was no major problem in the knee itself. Palpation of the adductor canal greatly aggravated the pain radiating below the knee. As local anaesthetic to the adductor canal eased the pain saphenous nerve impingement was suspected. Successful decompression of the nerve was performed and pain disappeared right after surgery. He was able to return to play ice hockey as a goalie three months after surgery. Even though iatrogenic injuries to saphenous nerve are common after orthopaedic operations, compression of the nerve in adductor canal is a rare condition that can cause problems in the differential diagnosis of knee pain. If needed, surgical treatment seems to yield a good outcome.
一名17岁的男性运动员出现右膝及下肢疼痛，近两年来对传统物理治疗和疼痛管理均无反应。他从小就担任冰球守门员，但由于疼痛无法重返赛场。他同一膝盖有过几次不同的受伤史，做过几次核磁共振成像扫描，看过几次医生，但都没有效果。身体活动尤其是膝盖伸展时疼痛会加剧，但膝盖本身没有大问题。触诊内收肌管会使膝盖以下放射痛明显加剧。由于向内收肌管注射局部麻醉剂后疼痛缓解，怀疑是隐神经受压迫。对该神经进行了成功减压，术后疼痛立即消失。术后三个月，他能够作为守门员重返冰球赛场。尽管骨科手术后隐神经的医源性损伤很常见，但内收肌管内神经受压是一种罕见情况，可能会给膝关节疼痛的鉴别诊断带来问题。如有需要，手术治疗似乎能取得良好效果。
