目的 探讨在辅助检查下精确定位后，采用小切口行股外侧皮神经（LFCN）松解术治疗骨盆骨折引起的感觉异常性股痛（MP）的疗效。 方法 对复旦大学附属华山医院手外科2019年6月至2022年6月间的6位骨盆骨折合并MP的患者进行了回顾性研究。其中4例骨盆骨折为保守治疗，1例为钢板内固定术后，1例为螺钉内固定术后。平均手术时间为伤后5。33（3~7）个月。所有患者术前都行超声和CT检查以明确卡压点，行LFCN松解后，对其术前及术后3个月、1年内（7~11个月）进行门诊随访，并记录所有患者的视觉模拟评分（VAS）。运用SPSS 26。0数据统计分析软件进行数据分析与处理，数据以均数±标准差（Mean±SD）表示。采用Friedman检验比较6例患者术前、术后第1次及第2次随访VAS评分差异，若差异有统计学意义，则进一步行成对比较，并采用Bonferroni矫正法调整显著性水平。P<0。05为差异有统计学意义。 结果 6例患者在进行神经松解术后，第1次术后随访VAS均下降，皮肤感觉异常区域缩小明显；第2次随访除1例患者VAS仍有2分外，其余患者均为0分，与术前相比差异有统计学意义（Friedman检验：χ2=12。0，P=0。002；成对t检验：P=0。002）。 结论 对于骨盆骨折合并MP，较易通过辅助检查发现LFCN的卡压点，定位后对其进行小切口的精准松解能够起到迅速彻底缓解疼痛与感觉异常的效果。 Objective To evaluate the efficacy in decompression of lateral femoral cutaneous nerve (LFCN) through a small incision， following precise localisation with auxiliary examinations， in the treatment of meralgia paraesthetica (MP) caused by pelvic fractures。 Methods A retrospective study was conducted on 6 patients with MP caused by pelvic fractures at the Department of Hand Surgery， Huashan Hospital， Fudan University between June 2019 and June 2022。 Among the 6 patients with MP caused by pelvic fractures， 4 were treated conservatively， 1 received an internal fixation with a steel plate， and the other received an internal fixation with screws。 The average time after the injury to surgery was 5。33 (range: 3-7) months。 Preoperative ultrasound and CT scans were performed to identify the sites of compression on LFCN。 After the decompression of LFCN， Visual analog scale (VAS) scores were employed to compare the therapeutic effectiveness with what that before surgery， at 3 months and within 1 year (7-11 months) after surgery。 SPSS 26。0 data statistical was used analysis software for data analysis and processing， the data was represented as (Mean ± SD)。 Friedman test was used to compare the differences in VAS scores among 6 patients before surgery， at first postoperative follow-up， and second postoperative follow-up。 If the differences were statistically significant， pairwise comparisons were further conducted， and the Bonferroni correction method was used to adjust the significance level。 P<0。05 indicated a statistically significant difference。 Results After the LFCN decompression， all patients showed a decrease in VAS scores with significantly reduced area of skin paraesthesia at the first postoperative follow-up review。 At the second review， all patients scored VAS zero， except 1 who was scored 2。 There was a statistically significant difference compared to preoperative VAS scores (Friedman test: χ2=12。0， P=0。002 paired t-test: P=0。002)。 Conclusion For the meralgia paraesthetica caused by pelvic fractures， compression points on LFCN can be easily identified through auxiliary examinations。 Precise release of the LFCN from compression through a small incision， after an accurate localisation， provides a rapid and complete relief of pain and sensory abnormalities。
Decompression of lateral femoral cutaneous nerve in treatment of meralgia paraesthetica caused by pelvic fracture
Objective To evaluate the efficacy in decompression of lateral femoral cutaneous nerve (LFCN) through a small incision, following precise localisation with auxiliary examinations, in the treatment of meralgia paraesthetica (MP) caused by pelvic fractures. Methods A retrospective study was conducted on 6 patients with MP caused by pelvic fractures at the Department of Hand Surgery, Huashan Hospital, Fudan University between June 2019 and June 2022. Among the 6 patients with MP caused by pelvic fractures, 4 were treated conservatively, 1 received an internal fixation with a steel plate, and the other received an internal fixation with screws. The average time after the injury to surgery was 5.33 (range: 3-7) months. Preoperative ultrasound and CT scans were performed to identify the sites of compression on LFCN. After the decompression of LFCN, Visual analog scale (VAS) scores were employed to compare the therapeutic effectiveness with what that before surgery, at 3 months and within 1 year (7-11 months) after surgery. SPSS 26.0 data statistical was used analysis software for data analysis and processing, the data was represented as (Mean ± SD). Friedman test was used to compare the differences in VAS scores among 6 patients before surgery, at first postoperative follow-up, and second postoperative follow-up. If the differences were statistically significant, pairwise comparisons were further conducted, and the Bonferroni correction method was used to adjust the significance level. P<0.05 indicated a statistically significant difference. Results After the LFCN decompression, all patients showed a decrease in VAS scores with significantly reduced area of skin paraesthesia at the first postoperative follow-up review. At the second review, all patients scored VAS zero, except 1 who was scored 2. There was a statistically significant difference compared to preoperative VAS scores (Friedman test: χ2=12.0, P=0.002 paired t-test: P=0.002). Conclusion For the meralgia paraesthetica caused by pelvic fractures, compression points on LFCN can be easily identified through auxiliary examinations. Precise release of the LFCN from compression through a small incision, after an accurate localisation, provides a rapid and complete relief of pain and sensory abnormalities.
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