Popliteal entrapment syndrome: a report of tibial nerve entrapment

A case of popliteal entrapment syndrome is reported, in which the patient experienced symptoms of tibial nerve entrapment. Exploratory surgery revealed an abnormal fibrous band between the heads of the gastrocnemius muscle that was compressing both the tibial nerve and popliteal artery. Division of this band provided immediate and lasting relief of the symptoms. This is believed to be the first report of a case of symptomatic entrapment of the tibial nerve.     

三种方法治疗肩胛上神经卡压综合征

目的:探讨不同方法治疗肩胛上神经卡压综合征的疗效。方法:肩胛上神经卡压综合征患者41例,男32例,女9例;年龄32～74岁,平均48岁;右侧29例,左侧12例;病程2个月～2.5年,平均9个月。30例采用局部封闭治疗,13例采用小针刀松解(其中包括局部封闭无效者7例),8例采用手术松解(其中包括小针刀松解无效3例)。局部封闭应用1%利多卡因5ml加曲安奈德40mg,每周1次,连续2～4次;小针刀采用切断肩胛上或下横韧带,肩胛岗上孔、岗下孔松解;手术在局麻直视下行肩胛上或下横韧带切断、松解肩胛上神经。结果:41例获随访,时间3个月～1年,依据疗效标准评定治疗效果。局部封闭组30例中,治愈2例,有效16例,无效12例;小针刀组13例中,治愈5例,有效5例,无效3例;手术松解组8例中,治愈6例,有效2例。结论:病程短、症状轻的患者应首选患者易接受的局部封闭治疗;症状严重且保守治疗无效者,采取小针刀松解或手术直视下神经松解,尤其是伴有肌萎缩者手术直视下松解更有必要。     

Entrapment neuropathy of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome: a case report

A case of the entrapment neuropathy of the palmar cutaneous branch of the median nerve, concomitant with carpal tunnel syndrome is presented. This report demonstrates that the Semmes-Weinstein monofilament test and nerve conduction studies can identify entrapment of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome.     

皮神经卡压综合征的治疗

皮神经卡压综合征治疗的关键在于减张减压。减张减压的机理有生物物理的也有生物化学的。追溯到古老的民间传统治疗疼痛的方法如刮痧和拔罐 ,其之所以解决问题 ,物理减压也是一个重要的因素。由于造成皮神经卡压的病因是复杂的 ,局部的病理改变也不是单一的。对它的治疗也绝非一方一法就能奏效的 ,所以审证求因 ,辨证施治是对皮神经卡压综合征治疗的基本原则。在方法的选择上 ,我们主张能用物理疗法的则不用药物疗法 ,能用非侵入疗法的则不用侵入疗法 ,能用有限侵入疗法的则不用手术切开疗法。关于皮神经卡压综合征的治疗 ,目前临床上大致可…     

Variation in morphology of suprascapular notch as a factor of suprascapular nerve entrapment

Purpose

The shape and size of the suprascapular notch (SSN) is one of the most important risk factors in suprascapular nerve entrapment. The aim of the study was to perform a morphological study of SSN variations.

Methods

A total of 616 computer tomography scans of scapulae were retrospectively analysed in 308 patients. The examination focused on the suprascapular region. The type of suprascapular notch was determined by using a classification based on three geometrical measurements: maximal depth (MD), superior (STD) and middle (MTD) transverse diameters.

Results

In the scans, five types of SSN were noted. In type I (24.18 %) maximal depth was greater than superior transverse diameter. Type II (1.95 %) has equal MD, STD and MTD. In type III (56.16 %) the superior transverse diameter was greater than the maximal depth. Scapulae with bony foramen were classified as type IV (4.72 %). In type V a discrete notch (12.99 %) was found. Additionally, types I and III were divided into three subtypes: A, B and C. The frequency of type I and IV was lower in females than in males, but type III was more common in females than males. Distribution of other types of SSN in both groups was similar.

Conclusion

Knowledge of the anatomical variations of the suprascapular notch described in this study should be helpful in endoscopic and open procedures of the suprascapular region and also may increase the safety of operative decompression of the suprascapular nerve.     

Intraneural ganglion of the suprascapular nerve: case report

We present a case of multicystic ganglion of the suprascapular nerve in an 18-year-old man. Pain and shoulder weakness were present and examination showed weakness and atrophy of the supraspinatus and infraspinatus muscles. Electromyography showed severe denervation of the infraspinatus and supraspinatus muscles. At surgery a multicystic lesion of the suprascapular nerve extending approximately 5.7 cm from its origin was resected and reconstructed by sural nerve grafting. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level V.     

中西医结合治疗肩胛上神经卡压综合征

肩胛上神经卡压综合征，临床报道较少。我院骨科自1992年1月至2002年1月，采用中西结合治疗肩胛上神经卡压综合征17例，疗效满意，现报告如下。     

股外侧皮神经卡压综合征长期误诊及误治1例

患者男,4 0岁,甘肃省某医院院长,因右下肢麻木、疼痛12年,加重3年,行走功能障碍,于2 0 0 1年9月来我院矫形外科就诊。患者1990年始出现右下肢股外侧麻木疼痛并放射到膝关节,长久站立行走则显著加重,曾于1994年、1995年在上海、北京几个大医院做骨科检查,磁共振显示“L3 ,4椎间盘突出”,经硬膜外腔封闭治疗5周无效,1996年始出现腰痛,曾在兰州某大医院行椎管造影无明显异常,并按“皮神经炎”药物封闭治疗无效。近3年来症状显著加重,站立行走不足10min即难以继续,仰卧睡觉有时亦会痛醒。既往病史:1982年在右臀外侧部有剧烈钝器外伤,无骨折及皮…     

皮神经卡压综合征的临床表现

皮神经卡压综合征是一个慢性渐进性的临床过程 ,主要表现为局部疼痛或感觉异常 ,局部肌肉紧张但不影响躯体运动 ,虽然有时临床症状复杂但病变部位表浅。1　疼痛皮神经卡压综合征的疼痛是一种慢痛 ,其特点是疼痛缓慢的产生 ,呈烧灼感 ,定位较差 ,持续时间久 ,有时呈难以忍受的疼痛。在临床上对皮神经卡压引起的疼痛进行分析时要注意疼痛的部位、时间、性质及组织特征 ,在纷杂的临床征状中理出一个清晰的诊断治疗思路 ,从而作出正确的诊断和鉴别诊断。1 1　疼痛的部位　皮神经卡压综合征疼痛的好发部位多见于颈、肩、腰、背、臀或四肢关节的骨…     

Anomalous palmar cutaneous branch of the median nerve in the distal forearm: case report

Variations exist in the anatomy of the palmar cutaneous branch of the median nerve about the wrist. We report an anatomic variation in the course of the palmar cutaneous branch of the median nerve identified in a 17-year-old girl undergoing surgery for a scaphoid nonunion. Instead of coursing ulnar to the flexor carpi radialis tendon, deep to the antebrachial fascia between the tendons of the flexor carpi radialis and palmaris longus, the palmar cutaneous branch of the median nerve was noted to cross volar to the distal aspect of the flexor carpi radialis to lie on its radial aspect. Knowledge of the anatomic variant described in this report should encourage surgeons to dissect carefully as they expose the flexor carpi radialis during the exposure of the distal radius or scaphoid.     

Neurectomy for anterior cutaneous nerve entrapment syndrome in children

Introduction

Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children.

Pudendal nerve entrapment in an Ironman athlete: a case report

Objective

To present the diagnostic and clinical features of pudendal nerve entrapment and create awareness amongst clinicians of this rare and painful condition.

Clinical Features

A 41-year old male ironman athlete complaining of insidious constant penis pain 12–24h after long distance cycling and pain after sexual intercourse. A diagnosis of “cyclist syndrome” also known as pudendal nerve entrapment was made.

Intervention and outcome

Patient was treated twice a week for four weeks using the soft tissue protocol described by Active Release Technique^® to the obturator internus muscle. After two weeks of treatment his pain decreased to a 5/10 on the pain intensity scale and he began to cycle again. After four weeks of treatment his pain had decreased to 1/10 in intensity and he continued to cycle. At follow-up, approximately 8 weeks and 12 weeks later the patient communicated that his pain is resolved and he has began to train for Ironman Lake Placid 2010.

Conclusion

Pudendal nerve entrapment is a rare, painful condition and is often misdiagnosed due to the fact that the clinical manifestations can mimic other pathologies. It is important to be aware of the clinical features to obtain appropriate diagnosis and treatment of this condition promptly.     

Suprascapular nerve entrapment by a ganglion cyst: a case report

A twenty-two-year-old male patient presented with complaints of muscle atrophy and shoulder pain. Clinical and radiological studies showed a ganglion cyst near the spinoglenoid notch and a diagnosis of compression of the inferior branch of the suprascapular nerve was made. Following open excision of the cyst by a posterior approach, the patient's complaints subsided. A year after the operation recurrence of the lesion was detected. Arthroscopic control showed no intrarticular lesion. The patient still experiences minimal pain from time to time.     

铍针治疗颈横皮神经卡压综合征

目的：探讨颈横皮神经卡压对颈部疼痛的影响及相应治疗方法。方法：对112例颈横皮神经卡压所致颈部疼痛的患者，采用铍针进行治疗，选取胸锁乳突肌后缘及颈椎棘突旁压痛点为进针点，并对治疗前后进行疗效评估。结果：112例患者平均随访16个月，其中治愈64例，显效36例，好转8例，无效4例，总有效率达97．15％。结论：颈横皮神经卡压可以导敛颈部疼痛，铍针治疗效果肯定。