Henderson Adam P, Kahrizi Mohammad S, Clendenen Steven R, Aziz Keith T
Mayo Clinic Alix School of Medicine, Jacksonville, Florida.
Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida.
J Orthop Case Rep. 2025 Sep;15(9):111-115. doi: 10.13107/jocr.2025.v15.i09.6034.
Neuropathic pain following trauma is a relatively common occurrence; however, diagnostic workup and treatment can be difficult. We present a case of chronic neuropathic pain in which surgical exploration and neurolysis yielded complete remission of pain. Histopathology revealed an array of findings, including evidence of fat necrosis with calcification, granuloma formation, and a foreign body, representing a particularly complex etiology for the patient's symptoms that has not, to our knowledge, been previously reported in the literature.
A 31-year-old female presented to our clinic with chronic neuropathic pain after sustaining a blunt injury to the medial aspect of the right leg 15 years previously while playing softball. Her pain was localized to the anteromedial lower leg and was not relieved by medical management and therapy. She temporarily had complete relief of her symptoms with ultrasound-guided hydrodissection. She was treated with surgical exploration and neurolysis, and postoperatively, the patient had no complications and complete relief of her pain.
We present a case of a 31-year-old patient who had perineural scarring and chronic neuropathic pain necessitating surgical exploration and neurolysis. Our case highlights the importance of investigating the etiology of neuropathic pain with several modalities and demonstrates the utility of ultrasound-guided peripheral nerve hydrodissection for both therapeutic and diagnostic purposes.
创伤后神经性疼痛较为常见；然而，诊断检查和治疗可能具有挑战性。我们报告一例慢性神经性疼痛病例，手术探查和神经松解使疼痛完全缓解。组织病理学检查发现一系列情况，包括脂肪坏死伴钙化、肉芽肿形成及异物，提示该患者症状的病因特别复杂，据我们所知，此前文献中尚未有过报道。
一名31岁女性因15年前打垒球时右小腿内侧受钝器伤后出现慢性神经性疼痛前来我院就诊。她的疼痛局限于小腿前内侧，药物治疗和理疗均无法缓解。超声引导下液体分离术曾使她的症状暂时完全缓解。她接受了手术探查和神经松解，术后未出现并发症，疼痛完全缓解。
我们报告一例31岁患者，其存在神经周围瘢痕形成及慢性神经性疼痛，需要进行手术探查和神经松解。我们的病例强调了采用多种方式探究神经性疼痛病因的重要性，并证明了超声引导下周围神经液体分离术在治疗和诊断方面的实用性。
