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髋关节翻修术后假性动脉瘤伴髂腰肌血肿所致股神经麻痹

Femoral nerve palsy associated with iliacus hematoma following pseudoaneurysm after revision hip arthroplasty.

作者信息

Nakamura Yoshihide, Mitsui Hiromasa, Toh Satoshi, Hayashi Yoshimitsu

机构信息

Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

出版信息

J Arthroplasty. 2008 Dec;23(8):1240.e1-4. doi: 10.1016/j.arth.2007.10.018. Epub 2008 Mar 14.

Abstract

Iliacus hematoma associated with femoral nerve palsy is a very rare but considerable complication of hip arthroplasty. A 76-year-old woman had femoral nerve palsy 6 months after revision hip arthroplasty using a reinforcement plate. Computed tomography and selective angiography revealed the pseudoaneurysm on an extension of one of the screws fixing the hardware. Transcatheter arterial embolization proximal to the aneurysm was performed to resolve the aneurysm and to prevent further bleeding. Surgical removal of the hematoma was successfully achieved, as was full functional recovery. This case report describes our diagnosis and treatment of this rare condition and also the therapeutic usefulness of the radiologic intervention to control further bleeding before and after surgical removal of the hematoma.

摘要

与股神经麻痹相关的髂肌血肿是髋关节置换术一种非常罕见但值得关注的并发症。一名76岁女性在使用加强钢板进行髋关节翻修术后6个月出现股神经麻痹。计算机断层扫描和选择性血管造影显示,固定硬件的其中一枚螺钉延长处存在假性动脉瘤。在动脉瘤近端进行经导管动脉栓塞术,以消除动脉瘤并防止进一步出血。成功实现了血肿的手术清除以及功能的完全恢复。本病例报告描述了我们对这种罕见病症的诊断和治疗,以及在血肿手术清除前后通过放射学干预控制进一步出血的治疗效用。

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