Schuh A, Riedel F, Craiovan B, Zeiler G
Orthopädische Klinik Rummelsberg, Schwarzenbruck.
Zentralbl Chir. 2003 Oct;128(10):871-3. doi: 10.1055/s-2003-44338.
Lesions of the sciatic or femoral nerve after THR are typical complications. Delayed neuropathies of the sciatic or femoral nerve are rare conditions.
We report the case of a delayed neuropathy of the sciatic nerve after THR with reconstruction of the acetabulum with an acetabular reinforcement ring. After electrophysiologic evaluation we performed a revision of the sciatic nerve. Intraoperatively we found an impingement of the sciatic nerve between the dorsal aspect of the acetabular reinforcement ring and scar tissue. After revision of the nerve, resection of the scar tissue and interposition of a fat pad the patient was out of any complaints but reported some sensory deficits of the first toe.
Using acetabular reinforcement rings for reconstruction of acetabular defects care has to be taken of the correct position. In anatomically cramped positions a protruding of the dorsal edge of the ring may cause a lesion of the sciatic nerve.
全髋关节置换术后坐骨神经或股神经损伤是典型并发症。坐骨神经或股神经迟发性神经病较为罕见。
我们报告一例全髋关节置换术后使用髋臼加强环重建髋臼导致坐骨神经迟发性神经病的病例。经电生理评估后,我们对坐骨神经进行了翻修。术中我们发现坐骨神经在髋臼加强环背侧与瘢痕组织之间受到压迫。对神经进行翻修、切除瘢痕组织并置入脂肪垫后,患者不再有任何不适,但报告第一趾有一些感觉缺失。
使用髋臼加强环重建髋臼缺损时,必须注意正确的位置。在解剖结构狭窄的部位,环的背侧边缘突出可能导致坐骨神经损伤。