Pudendal nerve palsy following fracture table traction.

In separate retrospective and prospective studies at the same Level 1 trauma center, pudendal nerve palsy complicating fracture table cases was analyzed. Incidence was established and pertinent variables categorized and compared. From January 1986 through October 1988, four of 216 fracture table patients (1.9%) were diagnosed with a postoperative pudendal nerve palsy. A subsequent three-month prospective study, ensuring use of preventive measures and incorporating active postoperative screening, resulted in only one of 36 patients (2.8%) developing this complication after fracture table traction. Symptoms associated with this palsy, including genitoperineal hypoesthesia, erectile dysfunction, or both, occurred within the first two postoperative days and resolved spontaneously by six months. No association of variables had any statistical significance. The pathoanatomy of this complication and preventive guidelines are reviewed.