femoral nerve entrapment syndrome
Introduction
Introduction to femoral nerve compression syndrome Femoral nerve venous pressure (femoralnerveentrapmentsyndrome) is caused by the stenosis of the sheath through the femoral nerve to cause compression of the femoral nerve. If the treatment is not timely, it often causes quadriceps paralysis that is difficult to recover. Mostly due to hip joint over-extension exercise, the iliopsoas muscle traction injury caused the disease. After the trauma, the incidence is often sudden and gradually worsened. basic knowledge The proportion of illness: 0.001% - 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: somatosensory disturbance
Cause
Causes of femoral nerve compression syndrome
(1) Causes of the disease
Mostly due to hip joint over-extension exercise, the iliopsoas muscle traction injury caused the disease.
(two) pathogenesis
The iliopsoas is surrounded by the iliopsoas fascia. In the inguinal region, the posterior and lateral sides are the humerus, the medial side is the pubic ligament, the anterior inguinal ligament, and the fascia contains the femoral nerve and the lateral femoral cutaneous nerve. A closed cavity (Fig. 1), under the inguinal ligament, thickens the fascia of the iliopsoas to form a fibrous arch, forming a dense sheath, causing a laceration of the iliopsoas muscle, causing edema in the fascia sheath , bleeding, etc., resulting in increased fascia subfascial tension, can compress the femoral nerve and lateral femoral cutaneous nerve, leading to nerve compression, common causes of hip joint extension caused by iliopsoas muscle traction The iliopsoas muscle is strongly contracted and injured, or the hemophilia patients may have local hematoma due to mild injury. In addition, improper operation may also cause local scars to oppress the nerves.
Prevention
Femoral nerve compression syndrome prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease. In addition to neurotrophic drugs, traditional Chinese medicine can be used to enhance the local blood circulation of nerve injury, and nerve regeneration cells can be used to stimulate the activation of lower limb function. When exercising, it is necessary to use a school-shaped shoe to protect the ankle joint from the wear-resistant foot deformity and cause bone wear and valgus.
Complication
Complications of femoral nerve compression syndrome Complications
Often complicated by lateral femoral cutaneous nerve compression syndrome.
1. Most patients have a history of flash injury and sprain in the waist and hips, which is more common in women.
2. Pain in the affected side, tingling, soreness or tearing pain, acute pain in the acute phase, and thigh pain in the thigh, but all over the knee, there are symptoms of numbness in the lower extremities, the pain is deep, the area is blurred, There are no obvious distribution boundaries.
3. Patients often have difficulty in sitting up. When they are changed from a sitting position to an upright position or sitting in an upright position, they feel that the waist and leg are not energetic and the pain is aggravated. They cannot sit up directly. They need to hold hands or support others to sit up.
4. The bending activity is limited, and the leg elevation is limited under the affected side, but there is no nerve root stimulation sign.
Symptom
Symptoms of femoral nerve compression syndrome Common symptoms Sensory disorder Knee extension Muscle muscle weakness Axillary pain
After the trauma, the incidence is often aggravated and gradually worsened. The progress of the disease is related to the relief of the iliopsoas muscle. The patient first complains of pain in the affected side of the armpit. The hip cannot be straightened, showing abduction and external rotation. It is often caused by muscle spasm caused by increased internal tension of the iliopsoas muscle. At this time, the affected axillary part can touch the mass or have a full feeling. There is obvious tenderness above the inguinal ligament, and there is tenderness in the lower abdomen. The neurological symptoms are often after the injury. It only occurs in an hour, which is related to the increase of intramuscular fascial sheath pressure. The anterior medial thigh is numb until the knee and the anterior medial leg, and then the knee extension is weak, the knee reflex is weak to disappear, and the quadriceps are gradually weak. Paralysis, muscle atrophy, intrinsic complication of lateral femoral cutaneous nerve compression, lateral skin sensory disturbance.
Examine
Examination of femoral nerve compression syndrome
Check for factor VIII (FVIII) to rule out hemophilia.
X-ray examination, often no positive findings, feasible MRI examination, helpful for diagnosis.
Diagnosis
Diagnosis and diagnosis of femoral nerve compression syndrome
There is a history of trauma, usually after the trauma, usually sudden and gradually worsened, partial fullness and tenderness is obvious, the hip can not be straight, showing abduction, external rotation, followed by knee extension, knee reflex Weak to disappear, the quadriceps are gradually weak and paralyzed, and then shrinking, which can establish a diagnosis.
