胫骨截肢后残肢的不自主运动:跳跃残肢综合征

Q3 Medicine Rehabilitacion Pub Date : 2023-04-01 DOI:10.1016/j.rh.2022.05.002
M. Hernández López, A.B. Puentes Gutiérrez, M.C. López Zarzuela, M. García Bascones
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引用次数: 1

摘要

45岁女性,有拇外翻手术史和发育迟缓,导致胫骨截肢。手术六个月后,她开始出现由触摸或髋关节伸展引发的残端不自主运动,如肌阵挛,这与之前残端的恶化和幻肢疼痛有关。在接下来的一年里,随着假体的更换,症状逐渐恶化,限制了行走。疼痛和肌阵挛的治疗方法最初是药理学的,没有反应。鉴于临床和超声怀疑腘-坐骨外神经有神经瘤,用皮质类固醇和麻醉剂浸润,用A型肉毒杆菌毒素浸润腓肠肌,但没有成功。最后,手术重建残端和切除神经瘤后,肌阵挛消失,疼痛减轻。这种临床表现被称为跳桩综合征,是截肢后必须考虑的罕见并发症。
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Movimientos involuntarios del muñón tras una amputación transtibial: síndrome del muñón saltarín

45-year-old woman with history of hallux valgus surgery and torpid evolution, which led to transtibial amputation. Six months after surgery, she began to experience involuntary movements of the stump such as myoclonus, that were triggered by touch or hip extension, associating worsening of the previous stump and phantom limb pain. During the following year, concurring with change of prosthesis, symptoms progressively worsened, which limited walking. The therapeutic approach to pain and myoclonus was initially pharmacological, without response. Given the clinical and ultrasound suspicion of neuroma in the external popliteal sciatic nerve, it was infiltrated with corticosteroid and anesthetic, and the gastrocnemius with botulinum toxin type A, without success. Finally, the myoclonus disappeared, and the pain decreased after surgical remodeling of the stump and resection of the neuroma. This clinical picture is known as jumping stump syndrome and is a rare complication that must be considered after amputation.

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来源期刊
Rehabilitacion
Rehabilitacion Medicine-Rehabilitation
CiteScore
0.80
自引率
0.00%
发文量
63
期刊介绍: La revista que es desde hace más de 40 años la publicación oficial de la Sociedad Española de Rehabilitación y referente de la mayoría de las Sociedades de la Especialidad de los países americanos de habla hispana. Se publican 5 números pluritemáticos al año y uno monográfico sobre un tema del mayor interés y actualidad designado por el consejo de redacción.
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