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神經截斷瘦小腿導致肌肉代償性肥大
林孟羲醫師的文章中有錯誤的地方:
橫紋肌溶解症的定義是:
肌肉嚴重受創後、運動過度、高壓電電擊、全身性痙攣、酗酒或服用過量安眠藥導致長期維持某一睡姿而造成局部肌肉壓迫、某些降血脂藥物等等。另外有些較少見的情形,例如大量蜂螫、毒蛇咬傷、服用搖頭丸、甚至近來令人談之色變的SARS(嚴重急性呼吸道症侯群)都會引起橫紋肌溶解症。
治療小腿肌肉肥厚的問題並不會造成全身肌肉的嚴重受創,連治療部位的肌肉也只有點狀的變化,所以不會有橫紋肌溶解症的可能。
搜索醫學文獻,只有看到神經截斷術的危險:
原文和病例圖片請看副檔的文件
選擇性神經截斷術後小腿肌肉的代償性肥大
Compensatory Hypertrophy of Calf Muscles After Selective Neurectomy
Choong Jae Lee, M.D., Jun Ho Park, M.D., and Sun Won Park, M.D.
Incheon, South Korea
Abstract.
Background: Unexpected contour changes frequently occurred
after surgical contouring of the calves by selective
neurectomy of the nerve to the medialgastrocnemius
muscle. We recently experienced a rather unusual case, in
which the nerve to the medialgastrocnemius muscle was
selectively transected on one side, whereas on the other side,
the nerve to the soleus was transected by mistake.
Methods: To investigate the reason for the contour change,
the authors compared the muscle volume ratio of the posterior
compartment of eight normalcal ves of eight normal
volunteers with two calves in the reported case by using
MRIs.
Results: The volume ration of normalcontrolcal ves was
0.22:0.12:0.66, respectively, for the medial and lateral gastrocnemius
muscles and the soleus muscle. In the case of the
calf with atrophy of the medial gastrocnemius muscle, the
volume ratio was 0.13:0.20:0.67, respectively. In the case of
the calf with atrophy of the soleus muscle, the volume ratio
was 0.27:0.14:0.59, respectively.
Conclusion: Physician and the patient should keep in mind
before the operation that even though one muscle in the calf
is selectively atrophied after the selective neurectomy, the
other muscles can hypertrophy for compensation, thus
causing possible distortion of aesthetic result.
Key words: Selective neurectomy—Compensatory hypertrophy—
Calf
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