Low to moderate risk of nerve damage during peroneus longus tendon autograft harvest
Low to moderate risk of nerve damage during peroneus longus tendon autograft harvest
复制标题
自体腓骨长肌腱移植过程中神经损伤的低至中度风险
DOI：
10.1007/s00167-021-06698-2
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发表时间：
2021-09-08
影响因子：
3.8
通讯作者：
Fu, Freddie
中科院分区：
文献类型：
--
作者：
He, Jinshen;Byrne, Kevin;Fu, Freddie
目的本研究旨在评估在自体腓骨长肌腱（PLT）移植物采集过程中肌腱剥离器与腓肠神经和腓肠神经的接近程度。方法采用10条新鲜冰冻的人下肢标本，使用标准闭合钝端肌腱剥离器收获全层自体血小板移植物。由两个独立的观察者使用ImageJ软件测量从PLT到腓肠神经的距离（在外踝（LM）近端0、1、2和3cm处），以及从肌腱剥离器的末端到腓神经及其分支的距离。结果在LM近端，PLT至腓肠神经的平均距离从0 ~ 2cm显著增加。LM处至腓肠神经的平均距离为4.9 +/- 1.5 mm，增加至10.8 +/- 2.4 mm（LM近端2 cm）。肌腱剥离器与腓深神经的距离平均为52.9 ± 11.4 mm，与腓神经的PLT分支的距离平均为29.3 ± 4.2 mm，腓浅神经与肌腱剥离器平行走行，距离肌腱剥离器末端平均为5.2 ± 0.7 mm。采集后，在10条腿中均未观察到神经横断损伤。结论本尸体研究发现，在全层PLT收获过程中，肌腱剥离器与神经之间的距离大于5 mm，建议在LM近端2 cm处进行初始切口。
Purpose This study aims to evaluate the proximity of the tendon stripper to both the peroneal and sural nerves during peroneus longus tendon (PLT) autograft harvesting. Methods Ten fresh-frozen human cadaveric lower extremities were used to harvest a full-thickness PLT autograft using a standard closed blunt-ended tendon stripper. The distance to the sural nerve from the PLT (at 0, 1, 2 and 3 cm proximal to lateral malleolus (LM), and the distance to the peroneal nerve and its branches from the end of the tendon stripper were measured by two separate observers using ImageJ software. Results The average distance from the PLT to the sural nerve increased significantly from 0 to 2 cm proximal to LM. The average distance to the sural nerve at the LM was 4.9 +/- 1.5 mm and increased to 10.8 +/- 2.4 mm (2 cm proximal to LM). The average distance from the tendon stripper to the deep peroneal nerve was 52.9 +/- 11.4 mm. The average distance to the PLT branch of peroneal nerve was 29.3 +/- 4.2 mm. The superficial peroneal nerve, which coursed parallel and deep to the tendon stripper, was on average 5.2 +/- 0.7 mm from the end of the stripper. No transection injuries of the nerves were observed in any of the ten legs after harvesting. Conclusion This cadaver study found during a full-thickness PLT harvest, the distances between the tendon stripper and the nerves were greater than 5 mm with an initial incision at 2 cm proximal to LM which is recommended.