Aksesuar derin peroneal sinir sıklığının elektrofizyolojik olarak saptanması
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Karabük Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Anormal sinir innervasyonları elektrofizyolojik çalışmalarda yanlış yorumlara neden olabilecek önemli nedenlerdendir. Aksesuar derin peroneal sinir alt ekstremitede en sık görülen anormal sinir innervasyonudur. Bu çalışmanın amacı elektrofizyolojik olarak saptanabilen aksesuar derin peroneal sinir sıklığını göstermektir. Kesitsel olan bu çalışmada Karabük Üniversitesi Eğitim ve Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniğine 01.01.2019-01.01.2020 tarihleri arasında başvuran ve çalışamaya alınma kriterlerini sağlayan sağlıklı gönüllüler elektrofizyolojik olarak incelenmiştir. Tüm katılımcılara rutin sinir iletim çalışması olarak bilateral alt ekstremite sural ve yüzeyel peroneal sinir duyu iletim çalışması, tibial ve peroneal sinir motor iletim çalışması yapılmıştır. Peroneal sinir motor iletim çalışmasında standart uyarım yerlerine ek olarak aksesuar derin peroneal sinir varlığını göstermek için lateral malleol arkasından uyarım yapılmıştır. İstatiksel analiz için SPSS 25 versiyonu kullanılmıştır. Anlamlılık için p<0.05 değeri kabul edilmiştir. Çalışmamızda 100 bayan ve 100 erkek olmak üzere 200 gönüllü, 400 alt ekstremite incelenmiştir. Aksesuar derin peroneal sinir varlığı incelenen 200 kişinin 24'ünde (%12), incelenen 400 ekstremitenin 37'sinde (%9.25) bulunmuştur. ADPS saptanan kişilerin 11'i (%45.8) kadın, 13'ü (%54.2) erkektir. ADPS varlığı ve cinsiyet arasında istatistiksel olarak anlamlı fark izlenmemiştir (p=0.66). ADPS saptanan olguların 13'ü (%54.2) bilateral, 11'i (%45.8) tek taraflıdır. ADPS'in tek taraflı ve bilateral olması arasında cinsiyete göre anlamlı fark izlenmemiştir (p=0.1). ADPS saptanan tek taraflı olguların 6 (%54.6) tanesi sağ, 5 (%45.4) tanesi sol alt ekstremitededir. ADPS'in sağ veya sol alt ekstremitede saptanması arasında istatistiksel olarak anlamlı fark izlenmemiştir (p=0.16). ADPS saptanan ekstremitelerde, ekstansör digitorum brevis kası %91.9 parsiyel, %8.1 total olarak ADPS ile innerve olmaktadır. Sonuç olarak bu çalışma ile elektrofizyolojik olarak saptanabilen ADPS sıklığı %12 olarak bulunmuştur (bacakların %9.25'inde). Özellikle alt ekstremite elektrofizyolojik çalışmalarında yanlış yorumlara neden olmamak için aksesuar derin peroneal sinir varlığı akılda tutulmalıdır. Anahtar Kelimeler: aksesuar derin peroneal sinir, peroneal sinir, anormal sinir innervasyonu
Abnormal nerve innervations are one of the important reasons that may cause misinterpretations in electrophysiological studies. Accessory deep peroneal nerve (ADPN) is the most common abnormal nerve innervation in the lower extremity. The aim of this study is to show the frequency of accessory deep peroneal nerve detectable electrophysiologically. In this cross-sectional study, healthy volunteers who applied to the Physical Medicine and Rehabilitation Clinic of Karabuk University Training and Research Hospital between 01.01.2019 and 01.01.2020 and who met the inclusion criteria for study were examined electrophysiologically. As a routine nerve conduction study, bilateral lower extremity sural and superficial peroneal nerve sensory conduction study, tibial and peroneal nerve motor transmission study was performed to all participants. In addition to the standard places of stimulation in peroneal nerve motor transmission work has been stimulated from the back of the lateral malleol to indicate the presence of the accessory deep peroneal nerve. SPSS 25 version was used for statistical analysis. A value of p<0.05 was accepted for significance. In our study, 200 volunteers, including 100 women and 100 men, 400 lower extremities were examined. The presence of accessory deep peroneal nerve was detected in 24 (12%) of 200 individuals examined, and in 37 (9.25%) of the 400 lower extremities examined. 11(45.8%) of people who detected having ADPS are female and 13(54.2%) of them are male. There was no statistically significant difference between the presence of ADPN and gender (p=0.66). The cases with ADPN 13 (54.2%) are bilateral, 11 (45.8%) are unilateral. There was no statistically significant difference between the unilateral and bilateral ADPN according to gender (p=0.1). The unilateral cases with ADPN 6 (54.6%) are in the right, 5 (45.4%) are in the left lower extremity. There was no statistically significant difference between detecting ADPN in the right or left lower extremity (p=0.16). In extremities with ADPN, extensor digitorum brevis muscle is innervated by ADPN 91.9% partially and 8.1% in total. As a result, the frequency of ADPS that can be detected electrophysiologically with this study was found to be 12% (9.25% of the legs). The presence of accessory deep peroneal nerve should be kept in mind to avoid misinterpretation especially in lower extremity electrophysiological studies. Keywords: accessory deep peroneal nerve, peroneal nerve, abnormal nerve innervation
Abnormal nerve innervations are one of the important reasons that may cause misinterpretations in electrophysiological studies. Accessory deep peroneal nerve (ADPN) is the most common abnormal nerve innervation in the lower extremity. The aim of this study is to show the frequency of accessory deep peroneal nerve detectable electrophysiologically. In this cross-sectional study, healthy volunteers who applied to the Physical Medicine and Rehabilitation Clinic of Karabuk University Training and Research Hospital between 01.01.2019 and 01.01.2020 and who met the inclusion criteria for study were examined electrophysiologically. As a routine nerve conduction study, bilateral lower extremity sural and superficial peroneal nerve sensory conduction study, tibial and peroneal nerve motor transmission study was performed to all participants. In addition to the standard places of stimulation in peroneal nerve motor transmission work has been stimulated from the back of the lateral malleol to indicate the presence of the accessory deep peroneal nerve. SPSS 25 version was used for statistical analysis. A value of p<0.05 was accepted for significance. In our study, 200 volunteers, including 100 women and 100 men, 400 lower extremities were examined. The presence of accessory deep peroneal nerve was detected in 24 (12%) of 200 individuals examined, and in 37 (9.25%) of the 400 lower extremities examined. 11(45.8%) of people who detected having ADPS are female and 13(54.2%) of them are male. There was no statistically significant difference between the presence of ADPN and gender (p=0.66). The cases with ADPN 13 (54.2%) are bilateral, 11 (45.8%) are unilateral. There was no statistically significant difference between the unilateral and bilateral ADPN according to gender (p=0.1). The unilateral cases with ADPN 6 (54.6%) are in the right, 5 (45.4%) are in the left lower extremity. There was no statistically significant difference between detecting ADPN in the right or left lower extremity (p=0.16). In extremities with ADPN, extensor digitorum brevis muscle is innervated by ADPN 91.9% partially and 8.1% in total. As a result, the frequency of ADPS that can be detected electrophysiologically with this study was found to be 12% (9.25% of the legs). The presence of accessory deep peroneal nerve should be kept in mind to avoid misinterpretation especially in lower extremity electrophysiological studies. Keywords: accessory deep peroneal nerve, peroneal nerve, abnormal nerve innervation
Açıklama
Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Ana Bilim Dalı
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
