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Hereditary Multiple Exostoses (HME) with Peroneal Nerve Compresion: A Case Report
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作者 Onarisa Ayu Muhammad Iqbal 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2023年第2期51-57,共7页
Introduction: Hereditary multiple exostosis (HME) is a hereditary disorder characterized by multiple osteochondromas. Clinical symptoms can result from compression of adjacent structures such as peripheral nerves. In ... Introduction: Hereditary multiple exostosis (HME) is a hereditary disorder characterized by multiple osteochondromas. Clinical symptoms can result from compression of adjacent structures such as peripheral nerves. In Indonesia, HME with nerve compression cases have rarely reported. Presentation of Case: An eleven-year-old female with complaining of left knee joint pain and progressive masses in left lower leg since 6 years ago. This complains followed by numbness and difficulty to dorso flexion motion on left ankle joint since four months ago. Physical examination showed of the bony masses was detected at the left lateral upper third lower leg with measuring about six into eight centimeters. Range of motion of left ankle joint patient had difficult to dorso flexion. X-ray imaging viewed demonstrates multiple exostosis appearance involving distal femoral, proximal fibula, proximal tibia and distal fibula bone. MR Imaging revealed cartilage cap of head fibula is thin less 1.5 cm and the axially specimen showed peroneal nerve compression. The patient underwent left head fibula wide resection. Intraoperative findings peripheral nerve peroneal compression and was decompression. Medical rehabilitation for physiotherapy was advised. The results of the follow-up after 2 years, no pain feels and the patient was able to dorso flexion of left ankle joint and no additional bumps in other areas of the body. These lesions may arise from any bone which was pre-formed in the cartilage. Nerve compression syndromes are the neurological complex symptom caused by the mechanical or dynamic compression of a specific single segment. MRI was excellent demonstration of blood vessels compromise and represents choices with peripheral nerves structures and to measuring cartilage cap thickness for criterion of osteochondromas differentiation and exostotic grade. Complete resection was importance of the cartilaginous cap to prevent recurrence. The decompressing the peroneal nerve that pressured by the masses and vascular problems occured. Conclusion: Hereditary multiple exostosis is an inherited disorder characterized by multiple osteochondromas. It is important to monitor all cases of HME especially if the patient complains of pain or growth of an osteochondroma. The surgical excision, with complete resection of the cartilaginous cap of the tumor, is important in preventing recurrence. 展开更多
关键词 OSTEOCHONDROMA Hereditary Multiple Exostosis (HME) peroneal nerve Compression
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Anatomical study of sciatic nerve and common peroneal nerve compression 被引量:1
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作者 Mingzhao Jia Qing Xia Jinmin Sun Qiang Zhou Weidong Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2008年第6期621-624,共4页
BACKGROUND: Many diseases of the common peroneal nerve are a result of sciatic nerve injury. The present study addresses whether anatomical positioning of the sciatic nerve is responsible for these injuries. OBJECTIV... BACKGROUND: Many diseases of the common peroneal nerve are a result of sciatic nerve injury. The present study addresses whether anatomical positioning of the sciatic nerve is responsible for these injuries. OBJECTIVE: To analyze anatomical causes of sciatic nerve and common peroneal nerve injury by studying the relationship between the sciatic nerve and piriformis. DESIGN, TIME AND SETTING: Observe and measure repeatedly. The experiment was conducted in the Department of Anatomy, Tianjin Medical College between January and June 2005. MATERIALS: Fifty-two adult cadavers 33 males and 19 females, with a total of 104 hemispheres, and fixed with formaldehyde, were provided by Tianjin Medical College and Tianjin Medical University. METHODS: A posterior cut was made from the lumbosacral region to the upper leg, fully exposing the piriformis and path of the sciatic nerve. MAIN OUTCOME MEASURES: (1) Anatomical characteristics of the tibial nerve and common peroneal nerve. (2) According to different areas where the sciatic nerve crosses the piriformis, the study was divided into two types-normal and abnormal. Normal is considered to be when the sciatic nerve passes through the infrapiriform foramen. Remaining pathways are considered to be abnormal. (3) Observe the relationship between the suprapiriform foramen, infrapiriform foramen, as well as the superior and inferior space of piriformis. RESULTS: (1) The nerve tract inside the common peroneal nerve is smaller and thinner, with less connective tissue than the tibial nerve. When pathological changes or variations of the piriformis, or over-abduction of the hip joint, occur, injury to the common peroneal nerve often arises due to blockage and compression. (2) A total of 76 hemispheres (73.08%) were normal, 28 were abnormal (26.92%). The piriformis can be injured, and the sciatic nerve can become compressed, when the hip joint undergoes intorsion, extorsion, or abduction. (3) The structures between the infrapiriform and suprapiriform foramen are where "the first threshold" sciatic nerve projects. The structures between the infrapiriform and suprapiriform gap were "the second threshold". This became the concept of "double threshold". The reduced area caused by pathological changes of "double threshold" may block and compress the sciatic nerve. Because the common peroneal nerve lies on the anterolateral side of the sciatic nerve, injury to the common peroneal nerve is more serious. CONCLUSION: Anatomical characteristics of the common peroneal nerve, as well as variation of the sciatic nerve, piriformis, and the reduced "double threshold", are the main causes of sciatic nerve injury, and are especially common in peroneal nerve injury. 展开更多
关键词 sciatic nerve injury common peroneal nerve disease PIRIFORMIS
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Electroacupuncture for Treatment of 12 Cases of Infantile Peroneal Nerve Injury
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作者 吕忠礼 陈志强 周永生 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2000年第2期130-131,共2页
Infantile peroneal nerve injury,also calledperoneal paralysis,is mostly caused by intraglutealinjection.Clinically,it is characterized by foot drop,strephenopodia,digital flexion,and high leg raisingwhile walking.The ... Infantile peroneal nerve injury,also calledperoneal paralysis,is mostly caused by intraglutealinjection.Clinically,it is characterized by foot drop,strephenopodia,digital flexion,and high leg raisingwhile walking.The authors have treated 12 cases ofperoneal nerve injury by electroacupuncture,withsatisfactory results reported as follows. 展开更多
关键词 Acupuncture Therapy ELECTROACUPUNCTURE CHILD Child Preschool Female Humans INFANT Male peroneal nerve peroneal Neuropathies
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Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature 被引量:2
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作者 Uday Guled Nirmal Raj Gopinathan Vijay G. Goni Arjun Rhh Rakesh John Prateek Behera 《Chinese Journal of Traumatology》 CAS CSCD 2015年第4期238-240,共3页
Either proximal tibial or tibial physeal injuries are rare. The combination of both is even rarer, let alone causes a vascular injury. Early intervention is the key for management. We hereby present an interesting cas... Either proximal tibial or tibial physeal injuries are rare. The combination of both is even rarer, let alone causes a vascular injury. Early intervention is the key for management. We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury. The present case is important in two aspects: firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury; secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients. 展开更多
关键词 physeal injury peroneal nerve Popliteal artery Tibia fracture
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Acupuncture for 24 cases of peroneal nerve palsy 被引量:1
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作者 柏树祥 《World Journal of Acupuncture-Moxibustion》 2012年第3期55-56,共2页
Objective To explore the effective therapy for peroneal nerve palsy.Methods Twenty-four cases of peroneal nerve palsy took acupuncture treatment,with acupoints of Bāfēng(八风 EX-LE 10),Tàichōng(太冲 LR 3),... Objective To explore the effective therapy for peroneal nerve palsy.Methods Twenty-four cases of peroneal nerve palsy took acupuncture treatment,with acupoints of Bāfēng(八风 EX-LE 10),Tàichōng(太冲 LR 3),Yánglíngquán(阳陵泉 GB 34),Xuánzhōng(悬钟 GB 39) etc.,once a day,10 times as a course.Results Twenty-four cases were all cured after 1-4 courses.Conclusion Acupuncture for peroneal nerve palsy shows a significant therapeutic effect. 展开更多
关键词 peroneal nerve palsy acupuncture therapy foot drop
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Electrical Stimulation of Deep Peroneal Nerve Mimicking Acupuncture Inhibits the Pressor Response via Capsaicin-lnsensitive Afferents in Anesthetized Rats
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作者 孙霞 蓝倩倩 +1 位作者 蔡勇 虞燕琴 《Chinese Journal of Integrative Medicine》 SCIE CAS 2012年第2期130-136,共7页
Objective: To assess the inhibitory modulation of blood pressure by stimulation of the deep peroneal nerve (DPN) and to determine the involvement of nociceptive fibers in the modulation. Methods: All the animals w... Objective: To assess the inhibitory modulation of blood pressure by stimulation of the deep peroneal nerve (DPN) and to determine the involvement of nociceptive fibers in the modulation. Methods: All the animals were divided into six groups (A-F). The rats in groups A and B received no pretreatment. The rats in groups C and D received subcutaneous injection of capsaicin or control vehicle, respectively, near the DPN for 2 days. Those in groups E and F had the DPN exposed to capsaicin or control vehicle, respectively, for 20 min. Subsequently, pressor responses were induced by stimulation of paraventricular nucleus (PVN) either electrically (groups A and C-F) or chemically via injection of glutamate (group B). After two stable pressor responses (baseline), all groups were subject to 5-min DPN stimulation followed by PVN stimulation for 10 s. Arterial blood pressure, heart rate, and electrocardiogram were recorded. The pressor response was calculated as the difference in the mean arterial pressure (MAP) before and after PVN stimulation, and changes from baseline in pressor response after DPN stimulation were compared between the groups. Results: Increases of MAP of 22.88 + 2.18 mm Hg and 20.32 + 5.25 mm Hg were induced by electrical (group A) or chemical (group B) stimulation of the PVN, respectively. These pressor responses were inhibited by stimulation of the DPN, and the MAP was reduced to 12.00 _+ 2.10 mm Hg in group A (n=6, P〈0.01) and 7.00 + 2.85 mm Hg in group B (n=6, P〈0.01). Subcutaneous injection of capsaicin (125 mg/kg) near the DPN in group C (n=7) had no effect on the inhibitory effect of DPN stimulation compared with the group D (n=9), and neither did blockade of nociceptive fibers with capsaicin in group E (n=6) compared with group F (n=8). Conclusion: Stimulation of the DPN mimicking acupuncture has an inhibitory effect on the pressor response, and the effect is mediated by capsaicin-insensitive afferent fibers in the DPN. 展开更多
关键词 ACUPUNCTURE deep peroneal nerve hypothalamic paraventricular nucleus pressor response capsaicin
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Predictive Reliability of the Phoenix Sign for the Outcome of Common Fibular (Peroneal) Nerve Decompression Surgery
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作者 Stephen L. Barrett Adam Khan +3 位作者 Victoria Brown Erik Rosas Sequioa Du Casse Porscha Bailey 《Open Journal of Orthopedics》 2020年第9期234-240,共7页
<span style="font-family:Verdana;">A positive Phoenix sign occurs when a patient, with a suspected focal nerve entrapment of the Common Fibular (Peroneal) Nerve (CFN) at the level of the fibular neck, ... <span style="font-family:Verdana;">A positive Phoenix sign occurs when a patient, with a suspected focal nerve entrapment of the Common Fibular (Peroneal) Nerve (CFN) at the level of the fibular neck, demonstrates an improvement in dorsifexion after an ultrasound guided infiltration of a sub-anesthetic dose of lidocaine. Less than</span><span style="font-family:""> </span><span style="font-family:Verdana;">5 cc’s of 1% or 2% lidocaine is utilized and the effect is seen within minutes after the infiltration, but usually lasts only 10 minutes. This effect may be due to the vasodilatory action of lidocaine on the microcirculation in the area of infiltration. This nerve block has significant diagnostic utility as it is highly specific in the confirmation of true focal entrapment of the CFN, has high predictive value for a patient who may undergo surgical nerve decompression if they have demonstrated a positive Phoenix Sign, and may help in the surgical decision-making process in patients who have had a drop foot for many years but still may regain some motor function after decompression. In this retrospective review, 26 patients were tested, and 25</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">of this cohort demon</span><span style="font-family:Verdana;">strated a Positive Phoenix Sign (an increase in dorsiflexion strength of the</span><span style="font-family:Verdana;"> Extensor Hallucis Longus muscle (EHL)). One patient had no response to the </span><span style="font-family:Verdana;">peripheral nerve block. Of the 25 patients who demonstrated a positive</span><span style="font-family:Verdana;"> “Phoenix Sign” and underwent nerve decompression of the CFN, and 25 (100%) showed an increase in dorsiflexion strength of the EHL after nerve decom</span><span style="font-family:Verdana;">pression surgery of the CFN. The one patient in this cohort who did not</span><span style="font-family:Verdana;"> dem</span><span style="font-family:Verdana;">onstrate any improvement in dorsiflexion of the EHL after the nerve block</span><span style="font-family:Verdana;"> did not have any improvement after surgery. 展开更多
关键词 Peripheral nerve Block Drop Foot Ultrasound Guidance Common peroneal nerve Entrapment Common Fibular nerve Entrapment
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Presentation and management outcome of foot drop with tibialis posterior tendon transfer
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作者 Muhammad Saaiq 《World Journal of Orthopedics》 2024年第11期1047-1055,共9页
BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait wh... BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait while walking.Overall,the gait is awkward;there is greater energy consumption;increased proneness to sustain injury of the forefoot;and more frequent falling during walking.AIM To document the clinical and epidemiological profile of foot drop patients in our population and evaluate the outcome of tibialis posterior(TP)tendon transfer for restoring the lost dorsiflexion in foot drop.METHODS The study was carried out at the National Institute of Rehabilitation Medicine in Islamabad over a period of 7 years.It included patients of all sexes and ages who presented with foot drop and had no contraindications for the procedure of TP tendon transfer.Exclusion criteria were patients who had contraindications for the operation.For instance,paralyzed posterior leg compartment muscles,Achilles tendon contracture,stiff ankle or toes,unstable ankle joint,weak gastrocnemius and scarred skin spanning over the route of planned tendon transfer.Also,patients who had the foot drop as a result of disc prolapses or brain diseases were excluded.Convenience sampling technique was used.The circum-tibial route of TP tendon transfer was employed.RESULTS Out of 37 patients,26(70.27%)were males whereas 11(29.72%)were females.The mean age was 22.59±8.19 years.Among the underlying causes of foot drop,road traffic accidents constituted the most common cause,found among 20(54.05%)patients.The share of complications included wound infections in 3(8.10%)patients and hypertrophic scars in 2(5.40%)patients.At 1-year postoperative follow-up visits,the outcome was excellent in 8(21.62%),good in 20(54.05%)and moderate in 9(24.31%).CONCLUSION The majority of cases of foot drop resulted from road traffic accidents that directly involved the common peroneal nerve.TP tendon transfer through the circumtibial route was found to be an easily executed effective operation which restored good dorsiflexion of the ankle among the majority of patients. 展开更多
关键词 Foot drop Common peroneal nerve peroneal nerve palsy Tibialis posterior transfer Tibialis anterior Tendon transfer
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Autologous transplantation with fewer fibers repairs large peripheral nerve defects 被引量:8
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作者 Jiu-xu Deng Dian-yin Zhang +7 位作者 Ming Li Jian Weng Yu-hui Kou Pei-xun Zhang Na Han Bo Chen Xiao-feng Yin Bao-guo Jiang 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第12期2077-2083,共7页
Peripheral nerve injury is a serious disease and its repair is challenging. A cable-style autologous graft is the gold standard for repairing long peripheral nerve defects; however, ensuring that the minimum number of... Peripheral nerve injury is a serious disease and its repair is challenging. A cable-style autologous graft is the gold standard for repairing long peripheral nerve defects; however, ensuring that the minimum number of transplanted nerve attains maximum therapeutic effect remains poorly understood. In this study, a rat model of common peroneal nerve defect was established by resecting a 10-mm long right common peroneal nerve. Rats receiving transplantation of the common peroneal nerve in situ were designated as the in situ graft group. Ipsilateral sural nerves(10–30 mm long) were resected to establish the one sural nerve graft group, two sural nerves cable-style nerve graft group and three sural nerves cable-style nerve graft group. Each bundle of the peroneal nerve was 10 mm long. To reduce the barrier effect due to invasion by surrounding tissue and connective-tissue overgrowth between neural stumps, small gap sleeve suture was used in both proximal and distal terminals to allow repair of the injured common peroneal nerve. At three months postoperatively, recovery of nerve function and morphology was observed using osmium tetroxide staining and functional detection. The results showed that the number of regenerated nerve fibers, common peroneal nerve function index, motor nerve conduction velocity, recovery of myodynamia, and wet weight ratios of tibialis anterior muscle were not significantly different among the one sural nerve graft group, two sural nerves cable-style nerve graft group, and three sural nerves cable-style nerve graft group. These data suggest that the repair effect achieved using one sural nerve graft with a lower number of nerve fibers is the same as that achieved using the two sural nerves cable-style nerve graft and three sural nerves cable-style nerve graft. This indicates that according to the ‘multiple amplification' phenomenon, one small nerve graft can provide a good therapeutic effect for a large peripheral nerve defect. 展开更多
关键词 nerve regeneration peripheral nerve injury peripheral nerve defect autologous nerve graft functional recovery nerve conductionvelocity sural nerve common peroneal nerve sleeve bridging suture neural regeneration
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Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery 被引量:3
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作者 Lu Bai Yan-ni Han +2 位作者 Wen-tao Zhang Wei Huang Hong-lei Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2015年第1期99-103,共5页
Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In ... Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa- tients received oral vitamin B^2 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func- tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months. 展开更多
关键词 nerve regeneration natural history cutaneous nerve injury foot and ankle sural nerve superficial peroneal nerve medial plantar nerve neurosensory function neural regeneration
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Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck
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作者 Rolf D Burghardt Thorsten Gehrke +2 位作者 Daniel Kendoff Ulrich Stockle Sebastian Siebenlist 《Chinese Journal of Traumatology》 CAS CSCD 2013年第5期308-310,共3页
Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead... Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia. The muscle com- partments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis, thus compensating higher volumes than the compartments in the lower leg. We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25- ton truck. He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and ab- sence of all foot pulses. CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg. The limb had a disas- trous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however, no bones in the limb were fractured. A complete fasciotomy of all the lower limb muscle compartments was immediately performed. The artery was reconstructed with interposition of the smaller saphenous vein, which was al- ready interrupted through the initial trauma. 展开更多
关键词 Compartment syndromes THIGH HEMORRHAGE Popliteal artery peroneal nerve
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