外源性压迫致腓总神经损伤的治疗

目的探讨外源性压迫因素所致腓总神经损伤的治疗方法。方法回顾分析了我院1995年8月～2005年8月收治的单纯外源性压迫所致腓总神经损伤病人32例的临床资料，其外源性压迫因素有石膏边缘卡压、小夹板及压垫压迫、牵引架布托卡压和下肢被动长时间外旋压伤腓骨颈处等。27例行保守治疗，方法包括电针灸配合应用药物熏洗、理疗、按摩、药物等；手术治疗5例，方法包括切开腓管减压、彻底松解神经周围粘连较重的组织，甚至将神经外膜松解。结果随访1～18个月，平均10个月，疗效优24例，良4例，可2例，差2例。2例差者均为病程超过6个月者，最终1例行肌腱移位，1例行踝关节融合术。结论外源性压迫所致腓总神经损伤的治疗越早效果越好，早期应以保守治疗为主，保守治疗超过3个月神经功能恢复停止者应行神经松解术治疗。

TREATMENT OF COMMON PERONEAL NERVE INJURY CAUSED BY EXTERNAL COMPRESSION

ObjectiveTo explore the therapy of injury of common peroneal nerve caused by external compression. MethodsThirty-two patients with injury of common peroneal nerve,caused by external compression,treated in our hospital(August,1995-August,2005) were reviewed.The reasons of compression included:plaster,small splint and pad,the cloth support of the traction rack,and the neck of fibula compressed due to long-time external rotation.Conservative therapy was carried out in 27 patients,which included electric acupuncture matching with herbal fumigation and bathing,physiotherapy,massage and medication.Surgery was done in five patients.The procedures included decompression of fibula canal,adhesiolysis of the tissue around the nerve,or decompression of the epineurium.ResultsThe follow-up time(average) was 1-18 months(10 months).The therapeutic efficacy was: excellence in 24 cases,good in four,fair in two,and poor in another two.The course of both the two patients with poor outcome was over six months,and tendon transfer was performed in one case and ankle fusion in another.ConclusionEarlier treatment of the common peroneal nerve injury caused by external compression will bring better result.The conservative treatment should be adopted in early stage.Neurolysis should be done for those who have been treated conservatively for over three months without signs of recovering.