A Case of Popliteal Pterygium Treated along with Nerve Expansion

Abstract

The presence of a short sciatic nerve in the free edge of a popliteal pterygium makes this syndrome a surgical challenge. We present a case of popliteal pterygium that was treated by nerve expansion. The range of motion of the patient's knee joint was between 30 and 120 degrees. A 75-cc tissue expander was placed under the sciatic nerve and filled with 5 cc of saline solution weekly. When a total of 60 cc was reached, wound dehiscence was observed, and the procedure had to be stopped. The maximum extension obtained was 160 degrees. Since the expansion process had to be stopped early, the elongation attained by expansion was less than expected. We conclude that the nerve expansion method can be used as a good alternative treatment modality for patients with popliteal pterygium.

Prenatal ultrasonographic diagnosis of the popliteal pterygium syndrome

“…Surgical correction of facial clefts give good aesthetic results (Audino et al, 1984). Conversely, the treatment of the popliteal web may be quite complicated in relation to the presence of the sciatic nerve in the free edge of the web (Maral et al, 1997). Moreover, the success rates are variable with a notable risk of recurrence of the web several years after treatment (Soekarman et al, 1995;FrosterIskenius, 1990).…”

MR Imaging of Popliteal Pterygium Syndrome in Pediatric Patients

“…Other syndromes specifically associated with pterygia include popliteal pterygium syndrome and Escobar syndrome (multiple pterygium syndrome) [2]. Popliteal pterygium syndrome is a rare, usually autosomal dominant disorder that represents the association of a popliteal web with a combination of facial, genitourinary, and skeletal abnormalities [1][2][3][4]. Facial abnormalities include lower lip pits, cleft palate, micrognathia, and choanal atresia.…”

“…Because pterygia result in an activity-limiting flexion deformity of the knee, surgical resection of the pterygium is often performed [1]. The popliteal artery and peroneal branch of the sciatic nerve are often abnormally positioned immediately adjacent to or in the pterygium [1][2][3][4]. It is helpful to know the exact position of these structures before attempting surgical resection of the pterygium or correction of the contracture so that these structures are not inadvertently transected during the surgery.…”

“…The MR appearance of a popliteal pterygium is that of a band of abnormal tissue extending from the ischium to the os calcis that has signal characteristics of fibrous tissue often attached to a belly of anomalous muscle. opliteal pterygium syndrome is the association of genitourinary and craniofacial anomalies with a webcausing connective tissue band extending from the ischium to the os calcis [1][2][3][4]. Surgical resection of the popliteal pterygium may be performed to relieve the resulting flexion deformity of the lower extremity [1][2][3][4].…”

“…opliteal pterygium syndrome is the association of genitourinary and craniofacial anomalies with a webcausing connective tissue band extending from the ischium to the os calcis [1][2][3][4]. Surgical resection of the popliteal pterygium may be performed to relieve the resulting flexion deformity of the lower extremity [1][2][3][4]. With popliteal pterygium, the positions of the popliteal artery and peroneal nerve are variable [1,2].…”