骨软骨瘤是最常见的原发性良性骨肿瘤之一。在大多数情况下，这种疾病是无症状的。然而，当影响膝关节时，可能会因神经和血管受压而出现症状。腓骨近端骨软骨瘤引起的孤立性胫神经麻痹很少见。一名 60 岁男性，因右膝退行性关节炎接受治疗，指 3 周前发生的右大脚趾屈曲受限。磁共振成像显示右膝受压由于腓骨头骨性病变而导致胫神经和周围肌肉的损伤。神经传导检查证实右小腿胫神经病变。进行探查手术，对胫神经减压并切除骨性病变，组织病理学诊断为骨软骨瘤。术后55个月，脚趾屈曲恢复正常。没有观察到骨软骨瘤复发。就像我们的病例一样，如果通过X光片诊断出骨性病变并伴有神经系统症状，则需要早期减压手术。此外，由于它可能被误诊为简单的骨刺，因此还需要进行磁共振成像和组织活检。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

Osteochondroma is one of the most common primary benign bone tumors. In most cases, this disease is asymptomatic. However, it may become symptomatic owing to nerve and vascular compression when it affects the knee joint. Isolated tibial nerve palsy caused by proximal fibular osteochondroma is rare.A 60-year-old male, was treated for degenerative arthritis of the right knee, referred to the right great toe flexion limitation that occurred 3 weeks prior.Magnetic resonance imaging revealed compression of the tibial nerve and surrounding muscles due to an osseous lesion in the fibular head. A nerve conduction test confirmed tibial neuropathy in the right lower leg.Exploratory surgery was performed to decompress the tibial nerve and remove the bony lesion histopathologically diagnosed as an osteochondroma.Fifty-five months postoperatively, toe flexion recovered to normal. No recurrence of osteochondroma was observed.As in our case, if a bony lesion is diagnosed on radiographs with neurological symptoms, early decompression surgery is necessary. Moreover, since it can be misdiagnosed as a simple bony spur, magnetic resonance imaging and tissue biopsy are also indicated.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.