四川医学2011，Vol.32Issue(3)：305-307,3.
胫神经缩窄术在治疗脑瘫下肢痉挛肢体中的应用
Neurotomy of the tibial nerve for treatment of spastic lower limbs in cerebral palsy.
摘要
Abstract
Objective To explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis in cerebral palsy. Methods A total of 27 cerebral palsy children with 53 spastic lower limbs were diagnosed with clear etiology, spastic muscles with supphed nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was located with electronic stimuli and monitored with induced electromyocardiogram. The surgical results were analyzed. Results 53 neurotomies of tibial nerve were done in 27 cases of cerebral palsy children with 53 spastic limbs. All patients were followed up from 6 to 15 months ( means 10. 3 months) ,and evaluated with dorsum flex of ankle joint, touching ground of feet, talipes equinovans, random movement improving evaluation and satisfactory grade of the parents. A total of 26 of 27 (96％) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 15 ～ 50 degree,and 16 of 19(84％ ) talipes aquinovarus improved chnically. Of 27 feet with surgery, 11 feet (40. 8％ ) were in normal position and could touch ground completely, 13 feet (48. 1％ ) had 10 degree with ground or could contact ground with external one third of the feet, 3 feet (11.1％) were abnormal. All patients were followed up from 6 to 15 months (means 10. 3 months). During follow-up, the random movement improving rate of spastic lower limbs is 81％ (22/27), 7 patients (26％)improved dramatically.Conclusion Neurotomy of tibial nerve is an effective method to treat talipes equinovarus, and can improve the motor activity of spastic lower limbs in cerebral palsy children.关键词
脑瘫/下肢痉挛肢体/内翻马蹄足/胫神经/神经缩窄术Key words
cerebral palsy/spastic lower limbs/talipes equinovarns/tibial nerve/neurotomy分类
医药卫生引用本文复制引用
谢轩贵,李鹏,蔡德成,张洪良,周学斌,蔡毅骁..胫神经缩窄术在治疗脑瘫下肢痉挛肢体中的应用[J].四川医学,2011,32(3):305-307,3.基金项目
四川省卫生厅资助项目(编号:100049) （编号:100049）
