neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2022-3-3-135-142neurojour-74Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESИнтраневральная синовиальная киста малоберцового нерва: анализ литературы и описание клинического случаяIntraneural synovial cyst of the peroneal nerve: literature review and description of a clinical casehttps://orcid.org/0000-0002-7651-8485КенисВладимир МарковичKenisVladimir M.

Д-р мед. наук, профессор, зам. директора по инновационному развитию и работе с регионами, руководитель отделения патологии стопы, нейроортопедии и системных заболеваний ФГБУ «НМИЦ детской травматологии и ортопедии имени Г.И. Турнера» Минздрава РФ, профессор кафедры детской травматологии и ортопедии ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РФ.

e-mail: kenis@mail.ru

MD, PhD, DSci., Professor, Deputy Director, Head of department of foot and ankle surgery, neuroorthopedics and skeletal dysplasias, H.Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery of the Ministry of Health of the Russian Federation, Saint-Petersburg, 196603, Russian Federation; Professor of the Department of Pediatric Traumatology and Orthopedics, I.I. Mechnikov North-Western State Medical University, Saint Petersburg, 191015, Russian Federation.

e-mail: kenis@mail.ru

kenis@mail.ruhttps://orcid.org/0000-0002-9353-6909ПаршинД. В.ParshinDmitriy V.noemail@neicon.ruhttps://orcid.org/0000-0002-5762-4477СапоговскийА. В.SapogovskiyAndrey V.noemail@neicon.ruФГБОУ ВО «Национальный медицинский исследовательский центр детской травматологии и ортопедии имени Г.И. Турнера» Минздрава РФ; ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РФH. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery of the Ministry of Health of the Russian Federation; I.I. Mechnikov North-Western State Medical UniversityКГБУЗ «Краевой психоневрологический детский санаторий»Regional psychoneurological children’s sanatoriumФГБОУ ВО «Национальный медицинский исследовательский центр детской травматологии и ортопедии имени Г.И. Турнера» Минздрава РФH. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery of the Ministry of Health of the Russian Federation20221810202233135142Copyright © Кенис В.М., Паршин Д.В., Сапоговский А.В., 20222022Кенис В.М., Паршин Д.В., Сапоговский А.В.Kenis V.M., Parshin D.V., Sapogovskiy A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/74

Интраневральные синовиальные кисты являются редким патологическим состоянием и могут быть симптоматическими из-за компрессии, которую они оказывают на соседние структуры, включая малоберцовый нерв (МБН).

Целью настоящей публикации является представление клинического случая интраневрального ганглия МБН с критическим анализом ошибок диагностики и тактики лечения, а также анализ данных современной отечественной и зарубежной научной литературы по данной проблеме.

У пациента с интраневральной кистой МБН на протяжении 1,5 лет с возраста 13 лет выполнено 3 оперативных вмешательства по иссечению образования, что не привело к восстановлению функции, а образование рецидивировало в прежнем объёме. Особенностью данного клинического случая является недооценка патогенеза описываемого состояния: наличие коммуникантного нерва между проксимальным межберцовым суставом и оболочками МБН, а также гиперпродукция синовиальной жидкости, источником которой служит проксимальный межберцовый сустав.

Настороженность в отношении данной патологии позволит повысить эффективность диагностики. Совместная целенаправленная работа детских неврологов, ортопедов, нейрофизиологов и радиологов может позволить сократить диагностический этап и дать возможность наиболее раннего и эффективного хирургического лечения во избежание необратимых последствий в результате длительной денервации мышц.

Участие авторов

Участие авторов:Кенис В.М. — концепция, написание текста;Паршин Д.В. — написание и редактирование текста;Сапоговский А.В. — написание и редактирование текста;Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 13

Поступила 13.07.2022 Принята к печати 25.08.2022Опубликована 30.09.2022

Introduction

Introduction. Intraneural synovial cyst is a rare pathological condition, which can be symptomatic due to the compression of the neighboring structures, including the peroneal nerve.

The purpose of this publication is to present a clinical case of intraneural ganglion of the peroneal nerve with a critical analysis of diagnostic and tactical errors in diagnosis and treatment tactics, and literature review. We present a clinical case of a patient with an intraneural cyst of the peroneal nerve, who had 3 surgical interventions over a period of 1.5 years from the age of 13 years, followed by recurrences without restoration of muscle function. The case demonstrates underestimation of the pathogenesis of the described condition — the presence of a communicant nerve between the proximal tibiofibular joint and the peroneal nerve and proximal tibiofemoral joint as the source of synovial effusion. Awareness in relation to this pathology will improve the efficiency of diagnosis. Interdisciplinary approach of pediatric neurologists, orthopedists, neurophysiologists and radiologists can shorten the diagnostic stage and enable the earliest and most effective surgical treatment to avoid irreversible consequences due to prolonged muscle denervation.

Contribution

Contribution:Kenis V.M. — concept, text writing;Parshin D.V. — text writing and editing;Sapogovskiy A.V. — text writing and editing.All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: July 13, 2022Accepted: August 25, 2022Published: September 30, 2022

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The authors declare that there are no conflicts of interest present.