A Rare Case of Tibioperoneal Arterial Trunk Entrapment Caused by a Fibular Osteochondroma

Argyriou, Christos; Drosos, Georgios I.; Tottas, Stylianos; Tasopoulou, Kalliopi-Maria; Georgiadis, George S.

doi:10.1016/j.avsg.2018.06.024

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…PES refers to a group of symptoms caused by mechanical compression of popliteal artery, vein or tibial nerve in the popliteal fossa. This is usually related to musculotendinous structures, but a few case reports described bony exostoses of the popliteal fossa causing PES [3,6]. Angiography and ultrasound are useful to define the precise level of vascular defects.…”

Section: Diagnosismentioning

confidence: 99%

“…Cartilage cap thickness > 2 cm in adults or >3 cm in children as well as new onset of pain or growth, or rapid growth of the lesion, especially after the closure of the growth plate, might reflect cancerous transformation [2]. The involvement of lower extremities is common, particularly metaphyseal structures of the femur and tibia around the knee joint [3,4]. Surgical resection is indicated for symptomatic lesions, complications, cosmetic reasons or malignant transformation.…”

Section: Introductionmentioning

confidence: 99%

“…Vascular complications are rare and include vessel perforation and thrombosis, arterial thromboembolic events and pseudoaneurysm formation [3]. From an epidemiologic point of view, pseudoaneurysms are most frequently observed compared to thromboembolic complications [5].…”

Section: Introductionmentioning

confidence: 99%

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Vascular Complications Caused by Tibial Osteochondroma: Focus on the Literature and Presentation of a Popliteal Artery Thrombosis with Acute Lower Limb Ischemia

Angelini

Ruggieri

2022

Diagnostics

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Osteochondromas are common benign bone tumors, frequently found in adolescents or young adults. Most often asymptomatic and discovered by accidental findings, they may be diagnosed because of compression or dislocation. Vascular complications are an atypical presentation of osteochondromas, and include vessel perforation and thrombosis, arterial thromboembolic events and pseudoaneurysm formation. Popliteal artery thrombosis and acute lower limb ischemia caused by a tibial osteochondroma are rarely observed. Starting from a case of temporary lower extremity ischaemia caused by thrombosis of the subarticular popliteal artery due to an osteochondroma of the proximal tibial protruding in popliteal fossa, we focused a literature analysis on diagnostic and management aspects. A combined vascular-orthopedic approach was performed with intra-arterial locoregional thrombolytic therapy and then a surgical tangential resection of the tibial osteochondroma. The adequate approach for these patients includes clinical evaluation, plain radiographs, CT scan and MRI. The purpose of the present review article is to underline the importance of a combined vascular-orthopedic approach to correct diagnosis and prompt surgical management of vascular complications caused by tibial osteochondromas.

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Section: Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vascular Complications Caused by Tibial Osteochondroma: Focus on the Literature and Presentation of a Popliteal Artery Thrombosis with Acute Lower Limb Ischemia

Angelini

Ruggieri

2022

Diagnostics

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“…45,46 CPN compression due to bony growths were also commonly reported in multiple case reports. [47][48][49][50] Two cases involved osteochondromas of the fibular head causing CPN entrapment, both of which achieved symptom resolution with tumor excision. 48,50 Rarer cases of bony overgrowth include melorheostosis, a bone hyperostosis disorder, and a fabella, a sesamoid bone in the posterolateral knee, causing CPN compression that required treatment with surgical removal of the bony lesions.…”

Section: Case Reports Common Peroneal Nervementioning

confidence: 99%

“…[47][48][49][50] Two cases involved osteochondromas of the fibular head causing CPN entrapment, both of which achieved symptom resolution with tumor excision. 48,50 Rarer cases of bony overgrowth include melorheostosis, a bone hyperostosis disorder, and a fabella, a sesamoid bone in the posterolateral knee, causing CPN compression that required treatment with surgical removal of the bony lesions. 47,49 Some cases of CPN entrapment secondary to muscular etiologies include a cadaver with an unusual anatomical variant of the distal biceps femoris and a diabetic patient who presented with peroneal muscle infarction treated with a splint and diabetic control.…”

Section: Case Reports Common Peroneal Nervementioning

confidence: 99%

An Update on Peroneal Nerve Entrapment and Neuropathy

et al. 2021

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Peroneal neuropathy is the most common compressive neuropathy of the lower extremity. It should be included in the differential diagnosis for patients presenting with foot drop, the pain of the lower extremity, or numbness of the lower extremity. Symptoms of peroneal neuropathy may occur due to compression of the common peroneal nerve (CPN), superficial peroneal nerve (SPN), or deep peroneal nerve (DPN), each with different clinical presentations. The CPN is most commonly compressed by the bony prominence of the fibula, the SPN most commonly entrapped as it exits the lateral compartment of the leg, and the DPN as it crosses underneath the extensor retinaculum. Accurate and timely diagnosis of any peroneal neuropathy is important to avoid progression of nerve injury and permanent nerve damage. The diagnosis is often made with physical exam findings of decreased strength, altered sensation, and gait abnormalities. Motor nerve conduction studies, electromyography studies, and diagnostic nerve blocks can also assist in diagnosis and prognosis. First-line treatments include removing anything that may be causing external compression, providing stability to unstable joints, and reducing inflammation. Although many peroneal nerve entrapments will resolve with observation and activity modification, surgical treatment is often required when entrapment is refractory to these conservative management strategies. Recently, additional options including microsurgical decompression and percutaneous peripheral nerve stimulation have been reported; however, large studies reporting outcomes are lacking.

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