Sammarco G J, Chalk D E, Feibel J H
University of Cincinnati, Ohio.
Foot Ankle. 1993 Feb;14(2):71-7. doi: 10.1177/107110079301400203.
Compression neuropathy in the lower extremity is common. The occurrence of more than one lesion of the nerve in the same limb is less frequent. Thirteen patients with 15 cases of tarsal tunnel syndrome associated with one or more additional lesions of the sciatic nerve or its branches of the same lower extremity are presented. Electrodiagnostic studies confirmed tarsal tunnel syndrome with conduction abnormalities at a number of locations along the sciatic, common peroneal, posterior tibial, or plantar nerves by mechanical impingement, metabolic axonal abnormality, or both. Seven of the 13 patients were treated with tarsal tunnel release. Six cases treated operatively improved significantly. Surgery on a previously operated foot or the existence of diabetes mellitus carried a fair prognosis. The association of back pain with or without previous surgery did not appear to affect the outcome of the tarsal tunnel release. No improvement in symptoms was apparent in the six unoperated patients during the period of the study. Multiple lesions of the nerves of a single extremity may account for the variable success rate of tarsal tunnel release.
下肢压迫性神经病变很常见。同一肢体出现多个神经病变的情况较少见。本文报告了13例患者，共15例跗管综合征，伴有坐骨神经或其同一下肢分支的一个或多个额外病变。电诊断研究证实了跗管综合征，其沿坐骨神经、腓总神经、胫后神经或足底神经的多个部位存在传导异常，原因是机械性压迫、代谢性轴索异常或两者皆有。13例患者中有7例行跗管松解术。6例接受手术治疗的患者有明显改善。既往手术过的足部进行手术或存在糖尿病，预后尚可。背痛伴或不伴既往手术似乎不影响跗管松解术的结果。在研究期间，6例未手术患者的症状无明显改善。单肢神经的多个病变可能是跗管松解术成功率不一的原因。
