PDF(Pubmed)
Abstract：
Reconstruction of the anterior cruciate ligament using autografts is a common procedure performed in the modern era. The peroneus longus tendon is an upcoming graft with several advantages over traditional autografts. It has minimal donor site morbidity in relation to biomechanical properties of the ankle. Common peroneal nerve injury during harvest is a theoretical concern while harvesting the peroneus longus tendon. The following case highlights the importance of careful surgical technique and timely intervention while dealing with such complications. A 25-year-old male suffered an anterior cruciate ligament rupture while wrestling. He had an unstable knee and difficulty performing daily activities. He underwent an arthroscopic anterior cruciate ligament reconstruction using peroneus longus tendon autograft. Following surgery, the patient reported a foot drop and decreased sensations over the dorsum of the foot. The patient was advised of a foot drop splint and neuroprotective medications. Neurophysiological studies were not performed since they cannot differentiate between partial and complete nerve injury in the first week after injury. A surgical exploration of the nerve was done. An intraneural hematoma was found with contusions over the peroneus longus tendon. Neurolysis was performed to decompress the nerve. The functioning of the anterior cruciate ligament was satisfactory during follow-up. An advancing Tinel\'s sign was noted on follow-up. The patient finally recovered after a 3-month follow-up.
摘要：
使用自体移植物重建前交叉韧带是现代常见的手术。腓骨长肌腱是即将到来的移植物，与传统的自体移植物相比具有许多优势。与踝关节的生物力学特性有关，它的供体部位发病率最低。收获腓骨长肌腱时，收获过程中常见的腓骨神经损伤是理论上的关注点。以下案例强调了在处理此类并发症时谨慎手术技术和及时干预的重要性。一名25岁的男性在摔跤时遭受了前十字韧带断裂。他的膝盖不稳定，难以进行日常活动。他使用腓骨长肌腱自体移植进行了关节镜前交叉韧带重建。手术后,患者报告脚下垂，脚背感觉下降。建议患者使用脚踏夹板和神经保护药物。未进行神经生理学研究，因为它们无法在损伤后的第一周区分部分和完全神经损伤。对神经进行了手术探查。发现神经内血肿，腓骨长肌腱上有挫伤。进行神经溶解以减压神经。随访期间前交叉韧带的功能令人满意。在后续行动中注意到了Tinel的前进标志。经过3个月的随访，患者最终康复。
