DeHart M M, Riley L H
Huebner Medical Center, San Antonio, Tex., USA.
J Am Acad Orthop Surg. 1999 Mar-Apr;7(2):101-11. doi: 10.5435/00124635-199903000-00003.
Nerve injury occurs in 1% to 2% of patients who undergo total hip arthroplasty and is more frequent in patients who need acetabular reconstruction for dysplasia and those undergoing revision arthroplasty. Injury to the peroneal division of the sciatic nerve is most common, but the superior gluteal, obturator, and femoral nerves can also be injured. Nerve injury can be classified as neurapraxia, axonotmesis, or neurotmesis. The worst prognosis is seen in patients with complete motor and sensory deficits and in patients with causalgic pain. Prevention is of overriding importance, but use of ankle-foot orthoses and prompt management of pain syndromes can be useful in the treatment of patients with nerve injury. Electrodiagnostic studies hold promise in complex cases; however, their intraoperative role requires objective, prospective, controlled scientific study before routine use can be recommended.
在接受全髋关节置换术的患者中，神经损伤发生率为1%至2%，在因发育不良需要髋臼重建的患者以及接受翻修置换术的患者中更为常见。坐骨神经腓总支损伤最为常见，但臀上神经、闭孔神经和股神经也可能受损。神经损伤可分为神经失用、轴突断裂或神经断裂。运动和感觉完全缺失的患者以及患有灼性神经痛的患者预后最差。预防至关重要，但使用踝足矫形器和及时处理疼痛综合征对神经损伤患者的治疗可能有用。电诊断研究在复杂病例中具有前景；然而，在推荐常规使用之前，其在术中的作用需要客观、前瞻性、对照的科学研究。
