Edelson R, Stevens P
Pediatric Orthopedic Associates, Salt Lake City, Utah 84113.
J Bone Joint Surg Am. 1994 Jul;76(7):993-9. doi: 10.2106/00004623-199407000-00006.
We reviewed the findings in twenty children and adolescents who had meralgia paresthetica, a common entity in adults that has only rarely been reported in children. Ten patients had bilateral involvement; thus, the study included thirty lesions. Twenty-four lesions were eventually treated with open decompression of the lateral femoral cutaneous nerve; the results of twenty-one of these operations were followed for at least two years. The presenting symptom was severe pain resulting in marked restriction of activities. The pain could be reproduced with palpation of the nerve, and a trial injection of Xylocaine (lidocaine) always produced transient relief of symptoms. The average age at the onset of the symptoms was ten years (range, one to seventeen years); the diagnosis was missed initially in ten patients, which resulted in multiple, unnecessary diagnostic tests being done. The average duration of the symptoms before the patient was first seen was twenty-four months (range, two to eighty-four months), and the average duration of follow-up after the twenty-one operations was thirty-eight months (range, twenty-five to sixty months). Fourteen of the twenty-one operations led to an excellent result, with complete relief of pain and no restriction of activities; five led to a good result, with occasional pain but no limitation of sports or other activities; and two led to a fair result, with pain that interfered with sports activities but not with walking. We believe that meralgia paresthetica is much more common in children than has been previously recognized.(ABSTRACT TRUNCATED AT 250 WORDS)
我们回顾了20例患有股外侧皮神经痛的儿童及青少年患者的情况,股外侧皮神经痛在成人中较为常见,但在儿童中鲜有报道。10例患者为双侧受累,因此该研究共纳入30处病损。24处病损最终接受了股外侧皮神经开放减压治疗,其中21例手术结果得到了至少两年的随访。主要症状为严重疼痛,导致活动明显受限。触诊神经时可诱发疼痛,注射一次赛罗卡因(利多卡因)总能使症状暂时缓解。症状出现时的平均年龄为10岁(范围1至17岁);最初有10例患者漏诊,导致进行了多项不必要的诊断检查。患者首次就诊前症状的平均持续时间为24个月(范围2至84个月),21例手术后的平均随访时间为38个月(范围25至60个月)。21例手术中有14例效果极佳,疼痛完全缓解,活动不受限;5例效果良好,偶尔有疼痛,但不限制运动或其他活动;2例效果尚可,疼痛影响体育活动,但不影响行走。我们认为股外侧皮神经痛在儿童中比以往认识到的更为常见。(摘要截选至250字)