隐神经髌下支卡压症

Entrapment Neuropathy of the Infrapatellar Branch of the Saphenous Nerve

目的从解剖和临床两方面探讨隐神经髋下支卡压症的的机制及诊治方法。方法解剖10具成人固定尸体,观察隐神经髌下支与周围结构的毗邻关系。对8例隐神经髌下支卡压症的患者进行临床观察和分析。结果30%(6侧)隐神经髌下支直接发自股神经,且不行走在Hunter′s管内。30%(6侧)从Hunter′s管内发自隐神经,并穿该管前壁腱板浅出。髋下支发出后80%(16侧)穿缝匠肌至膝内前下部,穿出点周围均为致密结缔组织。在膝内前下部髌下支和深筋膜紧密连在一起。8例患者,7例局封治疗,1例手术治疗,均取得了较好的效果。结论隐神经髌下支在行径途中多处可受到卡压,局封治疗一般可取得较好效果。

Objective To study the mechanism, diagnosis and treatment of the entrapment neuropathy of the infrapatellar branch of the saphenous nerve. Methods Anatomical study was done on both sides of 10 embalmed cadavers,the infrapatellar branch of the saphenous nerve were carefully dissected and observed. Eight cases with the infrapatellar branch of the saphenous nerve entrapment were treated and followed up. Results 30% infrapatellar branch of the saphenous nerve come from femoral nerve beyond the Hunter′s tunne l.30% infrapatellar branch of the saphenous nerve come from saphenous nerve in the Hunter′s tunnel and traverse the anterior cliff. 80% infrapatellar branch of the saphenous nerve run across sartorious muscle where was surrounded by tendinous tissue. At the medial and anterior side of knee joint, infrapatellar branch of the saphenous nerve was attached to deep fascia. Of all the eight patients, seven was treated by local block,one was treated by operation, all received good results. Conclusion There were a lot of structures that may cause the compression of infrapatellar branch of the saphenous nerve. local block is a good treatment which can receive preferably result.