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Forum Name: Surgery Topics
Question: Problems after lipoma extraction
|Mutius - Wed Aug 04, 2010 10:26 am||
Hello everyone, my name is Keith. I recently had 4 lipoma removed; two from my arm and two on my leg. The fourth and final cut is not healing well as it was located behind my right knee (near the surface and just above the joint on the thigh). It has been 5 days and what I originally assumed was anaesthetic I now believe to be nerve damage for I have a fair bit of numbness throughout the top section of my calf. All in all, I believe the scars are healing well, except the one behind my knee which is healing slower.
But to make matters worse, and the real reason I'm here, I also experience severe pulling in the popliteal region when I try to extend my leg beyond 95%. I can't walk without a severe limp which puts pressure on my knee and ankle. I can move my ankle and toes just fine, though. I should also mention that I'm suffering from effusion in each knee (from months ago) and it's only making matters worse.
Can someone tell me what I'm going through and how I recover from this? The nerve damage doesn't bother me so much anymore...
(Oh, and the doctor told me nothing. The surgery itself is a whole other story. But after stitching me up and freezing my leg he allowed me to walk out and drive home..)
|Dr.M.Aroon kamath - Fri Aug 06, 2010 9:34 am||
It is not very clear from your account whether the lipoma which was removed from the back of the knee was a subcutaneous lipoma or a deep seated lipoma(intramuscular or within the popliteal fossa).
The skin behind the knee and the skin overlying the calf are supplied by
- posterior cutaneous nerve of thigh(mid part),
- saphenous nerve(inner aspect), and
- lateral cutaneous nerve of leg(outer aspect).
Cutaneous nerves and their smaller branches are not generally visible in the course of surgical procedures.In the back of the thigh and popliteal fossa, these are all vertically oriented. Thus, although vertical incisions over the back of the thigh or the popliteal fossa have the advantage of sparing these nerves but, they have the chief disadvantage of causing scar contractures which may adversely affect movement of the knee joint.This is the reason why vertical (longitudinal) incisions across joints are discouraged.
Many a times the cutaneous nerves happen to get affected adversely by traction maneuvers in the course of surgical procedures(neurapraxia) rather than actually being severed.These deficits are temporary and recover with time.Small areas of sensory deficit tend to get covered by neighboring dermatomes.
Hopefully, your symptoms should get better soon. As for the restriction of joint movement , it should get better once the incision heals well and pain goes away.A bit of physio may be useful.
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