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Functional popliteal entrapment syndrome in the sportsperson

机译:运动员的功能性pop陷综合征

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摘要

Objective: To define the clinical syndrome of functional popliteal entrapment comparing pre and post surgical clinical outcomes with pre and post-operative provocative ultrasonic investigations. Further, to suggest a management pathway to differentiate chronic exertional compartment syndromes and concomitant venous popliteal compression. Methods: In 32 claudicant sportspersons, 55 limbs were characterised pre-surgery clinically, with provocative testing including hopping, and following a series of non-invasive tests. The clinical findings, ankle brachial indices (ABI) and duplex outcomes were compared pre-operatively, at 3 months post-operatively (n = 52) and in the long term i.e. 16 months (n = 17). Results: At 3 months, all 55 limbs had clinical follow up. 52 of the 55 limbs had follow up with ultrasound with provocative manoeuvres. The ABIs normalised in 46 (88%). There were 40 of 52 (76%) that became asymptomatic post surgery with a normal scan. There were 4 of 52 (8%) who were clinically asymptomatic but with residual obstruction on duplex and who were able to resume their usual lifestyle. There were 4 (8%) that had abnormal findings both on post-operative scan and clinically. Re-operation on 2 limbs corrected the duplex findings and the symptoms. There were 4 (8%) limbs that had normal duplexes but continued with symptoms albeit varied from the presenting symptoms. In the longer term, a further 2 became symptomatic at 2.8 years requiring a further successful intervention. (Concomitant popliteal venous obstruction was present in 5 limbs (10%) on standing.) Conclusions: In the claudicating sportsperson, where there are no well characterised specific anatomical abnormalities, the syndrome can be characterised by provocative clinical (particularly hopping) and non-invasive tests. A positive clinical outcome with surgery can be predicted by abnormal pre-surgical ultrasonic investigations and confirmed later by a similar normal post surgical study. Concomitant venous compression may occur while standing with both syndromes related to muscle hypertrophy.
机译:目的:确定功能性lite肌截留的临床综合征,将手术前后的临床结果与手术前后的超声检查进行比较。此外,提出了一种区分慢性劳累性室间隔综合征和伴随的静脉al神经压迫的管理途径。方法:在32名过分的运动员中,对55条肢体进行了术前临床表征,并进行了包括跳跃在内的挑衅性试验,并进行了一系列无创试验。术前,术后3个月(n = 52)和长期即16个月(n = 17)对临床发现,踝臂指数(ABI)和双工结局进行了比较。结果:在3个月时,所有55条肢体均接受了临床随访。 55例肢体中有52例接受了挑衅性的超声检查。 ABI正常化为46(88%)。 52例中有40例(76%)在正常扫描后无症状。 52名患者中有4名(8%)在临床上无症状,但双相残渣仍然存在,并且能够恢复通常的生活方式。术后扫描和临床检查中有4例(8%)的异常发现。 2条肢体再手术纠正了双相的发现和症状。有4(8%)肢体双工正常,但继续出现症状,尽管表现出的症状有所不同。从长远来看,在2.8年时又有2例出现症状,需要进一步成功干预。 (站立时有5条肢体同时发生pop静脉阻塞(占10%)。)结论:在没有明确特征的特定解剖异常的成年运动型运动员中,该综合征的特征可能是挑衅性的临床表现(特别是跳跃)和非侵入性测试。可以通过异常的术前超声检查来预测手术的阳性临床结果,并在以后通过类似的正常术后研究加以证实。站立与肌肉肥大有关的两种综合症时,可能会发生静脉压迫。

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