Julio Cesar Gali, Rodrigo de Souza Holtz, Marcello Scimini Lepispico, Enzo Barrio, João Otavyo Pereira Le Senechal, Julio Cesar Gali
{"title":"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?","authors":"Julio Cesar Gali, Rodrigo de Souza Holtz, Marcello Scimini Lepispico, Enzo Barrio, João Otavyo Pereira Le Senechal, Julio Cesar Gali","doi":"10.1590/1413-785220243204e277962","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>An oblique incision did not avoid IPBSN injuries. This condition rarely compromised the ADL. <b><i>Level of Evidence II, Lesser Quality Prospective Study.</i></b></p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460665/pdf/","citationCount":"0","resultStr":"{\"title\":\"CAN SENSORY DISTURBANCES DUE TO INJURY TO THE INFRAPATELLAR BRANCH OF THE SAPHENOUS NERVE BE PREVENTED BY AN OBLIQUE INCISION?\",\"authors\":\"Julio Cesar Gali, Rodrigo de Souza Holtz, Marcello Scimini Lepispico, Enzo Barrio, João Otavyo Pereira Le Senechal, Julio Cesar Gali\",\"doi\":\"10.1590/1413-785220243204e277962\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>An oblique incision did not avoid IPBSN injuries. This condition rarely compromised the ADL. <b><i>Level of Evidence II, Lesser Quality Prospective Study.</i></b></p>\",\"PeriodicalId\":55563,\"journal\":{\"name\":\"Acta Ortopedica Brasileira\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2024-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460665/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Ortopedica Brasileira\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/1413-785220243204e277962\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ortopedica Brasileira","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1413-785220243204e277962","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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.
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.