Mercimek hasatı palsisi: Tarım işçilerindeçömelerek calışmaya bağlı peroneal sinir felci

Abstract

Amaç: Mevsimsel tarım işçilerinde çömelerek uzun süreli çalışmaya bağlı olarak gelişmiş peroneal sinir felci hastalarını, klinik tablo ve elektrofizyolojik çalışmalarla değerlendirilerek takip ve tedavi sonuç¬larını sunuldu ve bu sorunun tedavisi ve önlenmesine yönelik bir yaklaşım yolu belirlemeye çalışıldı.

Çalışma planı: Polikliniğimize başvurmuş peroneal sinir felci hastalarından çömelerek çalışma hika¬yesi olan ve mevsimsel tarım işçisi 16 hastanın 18 ayağı retrospektif olarak değerlendirildi. Hastaların klinik ve nörolojik muayene değerlendirilmeleri not edildi ve kilo kaybı hikâyesi sorgulandı. Kilo ve boy değerleri elde edilerek vücut kitle indeksleri hesaplandı. Elektrofizyolojik testleri ile tanı doğrula¬narak lezyon yeri belirlendi. Tanı sonrası tüm hastalara medikal tedavi verildi ve ortez kullanması ve istirahat önerildi. Takipler sırasında hastalara ayak bileği hareketleri önerildi ve şikâyetleri geçen has¬taların ortez kullanımı sonlandırıldı. Takipler motor şikâyetlerin tamamen düzelmesine kadar yapıldı.

Bulgular: Tüm hastaların klinik ve nörofizyolojik değerlendirme sonucu izole peroneal sinir felci ile uyumlu idi. Çalışma kapsamına alınan 16 hastanın (9 kadın, 7 erkek) ortalama yaşı 23.6 idi. Yedi has¬tanın sol, yedi hastanın sağ ve iki hastanın her iki ekstremitede peroneal sinir felci geliştiği görüldü. Şikâyetlerin başlangıcının bir ile altı hafta arasında idi (ort. 3.1 hafta) ve günlük çömelerek çalışma süresi ortalama 6.8 saat idi (6 ile 8 saat arası). Ortalama iyileşme süresinin 7.3 hafta olduğu görüldü. Hiçbir hasta kilolu veya obez sınıfta değildi. On iki haftalık takipte iyileşme görülmeyen iki hastaya cerrahi gevşetme uygulandı.

Çıkarımlar: Peroneal sinir felcinde hastaların çalışma şekilleri ve meslekleri de göz önünde bulundu¬rulmalıdır. Çömelerek çalışmaya bağlı görülen peroneal sinir felcinde istirahat, konservatif tedavi ve yakın takip ile iyileşme beklenmelidir.

Keywords

• Peroneal sinir paralizi; sinir sıkışma sendromu; tuzak nöropati.

Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers

Abstract

Objective: The aim of this study was to evaluate the follow-up and treatment results of peroneal nerve palsy secondary to prolonged squatting for working and to determine an approach for its treatment and prevention.

Methods: The study retrospectively evaluated 16 patients (7 males, 9 females; mean age: 23.6 years) diagnosed with peroneal nerve palsy due to squatting for work. Clinical and neurological evaluations were performed and weight and height were measured. Lesion site was determined using electrophysiological testing. After diagnosis, medical and orthotic treatment was initiated and rest was advised.Patients were followed until motor symptoms were resolved.

Results: Clinical and neurophysiological evaluations were consistent with isolated peroneal nerve palsy. The left side was affected in seven patients, the right side in seven and both sides in two. Average onset of the symptoms was 3.3 (range: 1 to 6) weeks and average daily squatting period was 6.8 (range:6 to 8) hours. Average healing time was 7.4 (range: 3 to 16) weeks. None of the patients was obese or overweight. All patients healed with conservative treatment and no surgical treatment was necessary.

Conclusion: Working conditions and duties should be considered in the evaluation of peroneal nerve palsy. In peroneal nerve palsy secondary to squatting, healing should be expected with conservative treatment, resting and close follow-up.

Keywords

• Compression neuropathy
• entrapment neuropathy
• nerve compression syndrome
• peroneal nerve palsy

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