斜切口能否避免因隐神经髌下分支损伤而导致的感觉障碍?

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243204e277962
Julio Cesar Gali, Rodrigo de Souza Holtz, Marcello Scimini Lepispico, Enzo Barrio, João Otavyo Pereira Le Senechal, Julio Cesar Gali
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引用次数: 0

摘要

目的评估前交叉韧带重建术(ACLR)采用斜切口采集腘绳肌移植物后,隐神经髌下支(IPBSN)损伤的发生率:在前交叉韧带重建术后 6 个月的随访中,共对 57 名患者的 59 个膝关节进行了评估。我们在胫骨结节(TT)处画了一条与地面平行的水平线,穿过手术切口的最内侧部分,另一条与第一条水平线垂直。我们测量了切口的长度和角度、最内侧点到垂直线的距离以及胫骨结节到水平线的距离。我们用刷子测试了皮肤的敏感度,并测量了敏感度改变的区域。询问患者在日常生活活动(ADL)中遇到的困难:共有 27 个膝关节(45.7%)出现感觉障碍,其中 92.6% 的患者感觉障碍持续到术后第六个月。一个膝关节(3.7%)的日常活动能力受到影响。在年龄、患侧、切口角度或测量距离方面,敏感性发生变化的组别与未发生变化的组别之间没有发现明显差异。在敏感性无变化的组中,切口尺寸更大:结论:斜切口并不能避免 IPBSN 损伤。结论:斜切口并不能避免 IPBSN 损伤,这种情况很少会影响日常活动能力。证据等级 II,质量较低的前瞻性研究。
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CAN SENSORY DISTURBANCES DUE TO INJURY TO THE INFRAPATELLAR BRANCH OF THE SAPHENOUS NERVE BE PREVENTED BY AN OBLIQUE INCISION?

Objective: To evaluate the incidence of injuries to the infrapatellar branch of the saphenous nerve (IPBSN) after anterior cruciate ligament reconstruction (ACLR) with an oblique incision for hamstring graft harvesting.

Methods: In total, 59 knees (from 57 patients) were evaluated in the follow-up of ACLR for six months. We drew a horizontal line parallel to the ground, passing through the most medial portion of the surgical incision and another, perpendicular to the first, starting at the tibial tuberosity (TT). We measured the length and angle of the cut, the distances from its most medial point to the perpendicular line, and from the TT to the horizontal line. Skin sensitivity was tested with a brush and the altered sensitivity area was measured. Patients were asked about difficulties in activities daily of living (ADL).

Results: A total of 27 knees (45.7%) had sensory disorders, which persisted until the sixth postoperative month in 92.6% of them. The ADL were compromised in one knee (3.7%). No significant differences were found between the groups with and without changes in sensitivity regarding age, affected side, incision angle, or measured distances. The incision size was larger in the group without alteration in sensitivity.

Conclusions: An oblique incision did not avoid IPBSN injuries. This condition rarely compromised the ADL. Level of Evidence II, Lesser Quality Prospective Study.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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