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Mercimek hasatı palsisi: Tarım işçilerindeçömelerek calışmaya bağlı peroneal sinir felci

Yıl 2015, Cilt: 49 Sayı: 1, 45 - 50, 19.03.2015
https://doi.org/10.3944/AOTT.2015.14.0074

Öz

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.

Kaynakça

  • Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Pero- neal nerve entrapment. J Bone Joint Surg Am 1998;80:47- 53.
  • 2 Leach RE, Purnell MB, Saito A. Peroneal nerve entrap- ment in runners. Am J Sports Med 1989;17:287-91.
  • Mİller BN, Kadin S. Entrapment of the common pero- neal nerve. Am J Sports Med 1987;15:90-1.
  • Yilmaz E, Karakurt L, Serin E, Güzel H. Peroneal nerve palsy due to rare reasons: a report of three cases. [Article in Turkish] Acta Orthop Traumatol Turc 2004;38:75-8.
  • Yu JK, Yang JS, Kang SH, Cho YJ. Clinical characteristics of peroneal nerve palsy by posture. J Korean Neurosurg Soc 2013;53:269-73.
  • Sahai-Srivastava S, Amezcua L. Compressive neuropa- thies complicating normal childbirth: case report and lit- erature review. Birth 2007;34:173-5.
  • Babayev M, Bodack MP, Creatura C. Common peroneal neuropathy secondary to squatting during childbirth. Ob- stet Gynecol 1998;91:830-2.
  • Cruz-Martinez A, Arpa J, Palau F. Peroneal neuropathy after weight loss. J Peripher Nerv Syst 2000;5:101-5.
  • Mont MA, Dellon AL, Chen F, Hungerford MW, Krack- ow KA, Hungerford DS. The operative treatment of pero- neal nerve palsy. J Bone Joint Surg Am 1996;78:863-9.
  • Ramelli GP, Nagy L, Tuncdogan E, Mathis J. Ganglion cyst of the peroneal nerve: a differential diagnosis of peroneal nerve entrapment neuropathy. Eur Neurol 1999;41:56-8.
  • Bendszus M, Reiners K, Perez J, Solymosi L, Koltzenburg M. Peroneal nerve palsy caused by thrombosis of crural veins. Neurology 2002;58:1675-7.
  • Katirji B. Peroneal neuropathy. Neurol Clin 1999;17:567- 91.
  • Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuh- fried O, Vacariu G, Mittermaier C, et al. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med 2008;40:665-71.
  • Toğrol E. Bilateral peroneal nerve palsy induced by pro- longed squatting. Mil Med 2000;165:240-2.
  • Chiang AS, Tejwani NC. Acute compartment syndrome of the thigh: diagnosis and management. Eklem Hast Cer- rahisi 2007;18:72-7.
  • Watemberg N, Amsel S, Sadeh M, Lerman-Sagie T. Com- mon peroneal neuropathy due to surfing. J Child Neurol 2000;15:420-1.
  • Reif ME. Bilateral common peroneal nerve palsy second- ary to prolonged squatting in natural childbirth. Birth 1988;15:100-2.
  • Mitra A, Stern JD, Perrotta VJ, Moyer RA. Peroneal nerve entrapment in athletes. Ann Plast Surg 1995;35:366-8.
  • Koller RL, Blank NK. Strawberry pickers’ palsy. Arch Neurol 1980;37:320.
  • Schröter C, Braune HJ, Huffmann G. The so-called turnip-harvester palsy--a rare differential diagnosis to- day. [Article in German] Fortschr Neurol Psychiatr 1990;58:351-3. [Abstract]
  • Sangwan SS, Marya KM, Kundu ZS, Yadav V, Devgan A, Siwach RC. Compressive peroneal neuropathy during har- vesting season in Indian farmers. Trop Doct 2004;34:244- 6.
  • Papagianni A, Oulis P, Zambelis T, Kokotis P, Koulouris GC, Karandreas N. Clinical and neurophysiological study of peroneal nerve mononeuropathy after substantial weight loss in patients suffering from major depressive and schizophrenic disorder: Suggestions on patients’ manage- ment. J Brachial Plex Peripher Nerve Inj 2008;3:24.
  • Sotaniemi KA. Slimmer’s paralysis--peroneal neuropathy during weight reduction. J Neurol Neurosurg Psychiatry 1984;47:564-6.
  • Thoma A, Fawcett S, Ginty M, Veltri K. Decompression of the common peroneal nerve: experience with 20 con- secutive cases. Plast Reconstr Surg 2001;107:1183-9.
  • Vastamäki M. Decompression for peroneal nerve entrap- ment. Acta Orthop Scand 1986;57:551-4.
  • Uncini A, Di Muzio A, Awad J, Gambi D. Compressive bilateral peroneal neuropathy: serial electrophysiologic studies and pathophysiological remarks. Acta Neurol Scand 1992;85:66-70.
  • Ochoa J, Fowler TJ, Gilliatt RW. Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J Anat 1972;113:433-55.

Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers

Yıl 2015, Cilt: 49 Sayı: 1, 45 - 50, 19.03.2015
https://doi.org/10.3944/AOTT.2015.14.0074

Öz

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.

Kaynakça

  • Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Pero- neal nerve entrapment. J Bone Joint Surg Am 1998;80:47- 53.
  • 2 Leach RE, Purnell MB, Saito A. Peroneal nerve entrap- ment in runners. Am J Sports Med 1989;17:287-91.
  • Mİller BN, Kadin S. Entrapment of the common pero- neal nerve. Am J Sports Med 1987;15:90-1.
  • Yilmaz E, Karakurt L, Serin E, Güzel H. Peroneal nerve palsy due to rare reasons: a report of three cases. [Article in Turkish] Acta Orthop Traumatol Turc 2004;38:75-8.
  • Yu JK, Yang JS, Kang SH, Cho YJ. Clinical characteristics of peroneal nerve palsy by posture. J Korean Neurosurg Soc 2013;53:269-73.
  • Sahai-Srivastava S, Amezcua L. Compressive neuropa- thies complicating normal childbirth: case report and lit- erature review. Birth 2007;34:173-5.
  • Babayev M, Bodack MP, Creatura C. Common peroneal neuropathy secondary to squatting during childbirth. Ob- stet Gynecol 1998;91:830-2.
  • Cruz-Martinez A, Arpa J, Palau F. Peroneal neuropathy after weight loss. J Peripher Nerv Syst 2000;5:101-5.
  • Mont MA, Dellon AL, Chen F, Hungerford MW, Krack- ow KA, Hungerford DS. The operative treatment of pero- neal nerve palsy. J Bone Joint Surg Am 1996;78:863-9.
  • Ramelli GP, Nagy L, Tuncdogan E, Mathis J. Ganglion cyst of the peroneal nerve: a differential diagnosis of peroneal nerve entrapment neuropathy. Eur Neurol 1999;41:56-8.
  • Bendszus M, Reiners K, Perez J, Solymosi L, Koltzenburg M. Peroneal nerve palsy caused by thrombosis of crural veins. Neurology 2002;58:1675-7.
  • Katirji B. Peroneal neuropathy. Neurol Clin 1999;17:567- 91.
  • Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuh- fried O, Vacariu G, Mittermaier C, et al. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med 2008;40:665-71.
  • Toğrol E. Bilateral peroneal nerve palsy induced by pro- longed squatting. Mil Med 2000;165:240-2.
  • Chiang AS, Tejwani NC. Acute compartment syndrome of the thigh: diagnosis and management. Eklem Hast Cer- rahisi 2007;18:72-7.
  • Watemberg N, Amsel S, Sadeh M, Lerman-Sagie T. Com- mon peroneal neuropathy due to surfing. J Child Neurol 2000;15:420-1.
  • Reif ME. Bilateral common peroneal nerve palsy second- ary to prolonged squatting in natural childbirth. Birth 1988;15:100-2.
  • Mitra A, Stern JD, Perrotta VJ, Moyer RA. Peroneal nerve entrapment in athletes. Ann Plast Surg 1995;35:366-8.
  • Koller RL, Blank NK. Strawberry pickers’ palsy. Arch Neurol 1980;37:320.
  • Schröter C, Braune HJ, Huffmann G. The so-called turnip-harvester palsy--a rare differential diagnosis to- day. [Article in German] Fortschr Neurol Psychiatr 1990;58:351-3. [Abstract]
  • Sangwan SS, Marya KM, Kundu ZS, Yadav V, Devgan A, Siwach RC. Compressive peroneal neuropathy during har- vesting season in Indian farmers. Trop Doct 2004;34:244- 6.
  • Papagianni A, Oulis P, Zambelis T, Kokotis P, Koulouris GC, Karandreas N. Clinical and neurophysiological study of peroneal nerve mononeuropathy after substantial weight loss in patients suffering from major depressive and schizophrenic disorder: Suggestions on patients’ manage- ment. J Brachial Plex Peripher Nerve Inj 2008;3:24.
  • Sotaniemi KA. Slimmer’s paralysis--peroneal neuropathy during weight reduction. J Neurol Neurosurg Psychiatry 1984;47:564-6.
  • Thoma A, Fawcett S, Ginty M, Veltri K. Decompression of the common peroneal nerve: experience with 20 con- secutive cases. Plast Reconstr Surg 2001;107:1183-9.
  • Vastamäki M. Decompression for peroneal nerve entrap- ment. Acta Orthop Scand 1986;57:551-4.
  • Uncini A, Di Muzio A, Awad J, Gambi D. Compressive bilateral peroneal neuropathy: serial electrophysiologic studies and pathophysiological remarks. Acta Neurol Scand 1992;85:66-70.
  • Ochoa J, Fowler TJ, Gilliatt RW. Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J Anat 1972;113:433-55.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orijinal Makale
Yazarlar

Serkan Sipahioglu Bu kişi benim

Sinan Zehir Bu kişi benim

Huseyin Askar Bu kişi benim

Ugur Isikan Bu kişi benim

Yayımlanma Tarihi 19 Mart 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 49 Sayı: 1

Kaynak Göster

APA Sipahioglu, S., Zehir, S., Askar, H., Isikan, U. (2015). Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers. Acta Orthopaedica Et Traumatologica Turcica, 49(1), 45-50. https://doi.org/10.3944/AOTT.2015.14.0074
AMA Sipahioglu S, Zehir S, Askar H, Isikan U. Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers. Acta Orthopaedica et Traumatologica Turcica. Mart 2015;49(1):45-50. doi:10.3944/AOTT.2015.14.0074
Chicago Sipahioglu, Serkan, Sinan Zehir, Huseyin Askar, ve Ugur Isikan. “Peroneal Nerve Palsy Secondary to Prolonged Squatting in Seasonal Farmworkers”. Acta Orthopaedica Et Traumatologica Turcica 49, sy. 1 (Mart 2015): 45-50. https://doi.org/10.3944/AOTT.2015.14.0074.
EndNote Sipahioglu S, Zehir S, Askar H, Isikan U (01 Mart 2015) Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers. Acta Orthopaedica et Traumatologica Turcica 49 1 45–50.
IEEE S. Sipahioglu, S. Zehir, H. Askar, ve U. Isikan, “Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers”, Acta Orthopaedica et Traumatologica Turcica, c. 49, sy. 1, ss. 45–50, 2015, doi: 10.3944/AOTT.2015.14.0074.
ISNAD Sipahioglu, Serkan vd. “Peroneal Nerve Palsy Secondary to Prolonged Squatting in Seasonal Farmworkers”. Acta Orthopaedica et Traumatologica Turcica 49/1 (Mart 2015), 45-50. https://doi.org/10.3944/AOTT.2015.14.0074.
JAMA Sipahioglu S, Zehir S, Askar H, Isikan U. Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers. Acta Orthopaedica et Traumatologica Turcica. 2015;49:45–50.
MLA Sipahioglu, Serkan vd. “Peroneal Nerve Palsy Secondary to Prolonged Squatting in Seasonal Farmworkers”. Acta Orthopaedica Et Traumatologica Turcica, c. 49, sy. 1, 2015, ss. 45-50, doi:10.3944/AOTT.2015.14.0074.
Vancouver Sipahioglu S, Zehir S, Askar H, Isikan U. Peroneal nerve palsy secondary to prolonged squatting in seasonal farmworkers. Acta Orthopaedica et Traumatologica Turcica. 2015;49(1):45-50.