上胫腓关节液流注性囊肿致腓总神经卡压的外科治疗

摘要

Objective To analyze the pathogenesis,treatment and prognosis of the conmon peroneal nerve compression by cyst arising from the proximal tibiofibular joint.Methods Nine cases of common peroneal nerve compression treated from June 2008 to December 2010 were analyzed.The cause of neuropathy was compression by cystic fluid arising from the proximal tibiofibular joint.Results There were 6 cases of extraneural cyst.Cyst excision and neurolysis of the common peroneal nerve was carried out.Dorsiflexion muscles of the ankle and toe extensors recovered MRC 4 to 5 strength.The average recovery time was 3.5 months.Three eases were diagnosed as intraneural cyst.The same operation was done.Muscle power of ankle dorsiflexors and toe extensors reached MRC 3 to 4 strength and the average recovery time was 7 months.There was no recurrence.Condusion Extrusion of joint fluid from the proximal tibiofibular joint can form extra-or intraneural cysts causing compression of the common peroneal nerve.The prognosis of intraneural cysts is worse than that of extraneural cysts.The sooner the diagnosis and surgical treatment,the better the functional recovery.%目的 分析上胫腓关节液流注性囊肿致腓总神经损伤的发病机制、诊疗方法及预后情况.方法 对我科2008年6月至2010年12月收治的因上胫腓关节液流注致腓总神经卡压的9例患者进行分析.结果 6例神经外囊肿患者经神经松解、囊肿切除术后踝关节及各趾背伸肌力达M4～M5,平均恢复时间约3.5个月；3例神经内囊肿患者经同一术式治疗,背伸肌力达M3～M4,平均恢复时间7个月.未见复发病例.结论 上胫腓关节液流注可形成腓总神经内或外囊肿,神经内囊肿较神经外囊肿恢复时间长、效果差.此类疾病早诊治,早治疗,患肢功能恢复好.