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Earthquake generated proximal tibial nerve compression treated by surgery.
Peifu Tang1, Qing He, Chao Chen
1Department of Orthopaedics, General Hospital, Beijing, China.
International Orthopaedics
|June 19, 2013
Summary
Improper treatment of acute compartment syndrome (ACS) can cause tibial nerve compression. Surgical neurolysis relieved pain and improved nerve function in most patients, offering a potential treatment for this complication.
Area of Science:
- Orthopedics
- Neurology
- Trauma Surgery
Background:
- Acute compartment syndrome (ACS) in the lower extremity requires timely treatment.
- Inappropriate management of ACS can lead to secondary complications, including nerve entrapment.
Purpose of the Study:
- To report cases of proximal tibial nerve compression caused by the soleal tendinous arch following ACS treatment.
- To analyze the etiology of this specific neurological compression.
- To evaluate the clinical outcomes of neurolysis for this condition.
Main Methods:
- Nine patients with tibial nerve compression secondary to ACS were treated with neurolysis and division of the soleal tendinous arch.
- Pre- and post-operative assessments included pain levels, sensory function (numbness), motor strength (flexor hallucis longus), and Tinel's sign.
Main Results:
- At a mean 22-month follow-up, significant improvements were observed in motor strength (87%) and sensory function (78%).
- All patients reported pain relief, with visual analogue scale scores decreasing from 2.7 to 0.7.
- Functional recovery led to high or satisfactory patient outcomes in 8 out of 9 cases.
Conclusions:
- Untreated or improperly treated lower extremity ACS can result in tibial nerve compression under the soleal tendinous arch.
- Neurolysis offers a viable treatment option, effectively alleviating pain and restoring sensory and motor functions.
