Young N L, Davis R J, Bell D F, Redmond D M
Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Orthop. 1993 Jul-Aug;13(4):473-7. doi: 10.1097/01241398-199307000-00011.
Clinical observation of several hundred Ilizarov patients has demonstrated prolonged muscle weakness in the involved limb after treatment. The etiology may be either neuropathic or myopathic. Direct intraoperative neural injury is unusual but generally is detected immediately postoperatively. We wished to determine the etiology of this clinical problem. Six consecutive patients completing tibial lengthening by the Ilizarov method were examined by electrodiagnostic methods. All patients were clinically normal. Electrodiagnostic testing showed abnormalities in six of six deep peroneal nerves. Five of six demonstrated abnormalities in the superficial peroneal sensory responses. In addition, two of six patients demonstrated abnormalities related to the posterior tibial nerve. Concomitantly, sequential perioperative limb compartment pressure studies were performed in nine patients undergoing 12 tibial applications of the Ilizarov technique. Increases in mean compartment pressures to between 20 and 30 mm Hg were demonstrated after tibial osteotomy and in the first 18 hours postoperatively.
对数百名采用伊里扎洛夫技术治疗的患者进行的临床观察表明，治疗后受累肢体存在长期肌肉无力的情况。其病因可能是神经性的，也可能是肌病性的。术中直接神经损伤并不常见，但一般在术后立即就能检测到。我们希望确定这一临床问题的病因。对连续6例采用伊里扎洛夫方法完成胫骨延长术的患者进行了电诊断检查。所有患者临床症状均正常。电诊断测试显示，6条腓深神经均存在异常。6条腓浅神经感觉反应中有5条显示异常。此外，6例患者中有2例显示与胫后神经相关的异常。同时，对9例接受12次伊里扎洛夫技术胫骨应用的患者进行了围手术期肢体筋膜室压力的连续研究。胫骨截骨术后及术后18小时内，平均筋膜室压力升高至20至30毫米汞柱之间。
