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成功将一只猫的股骨头切除术(术后并发坐骨神经失用症)翻修为全髋关节置换术。

Successful revision of a femoral head ostectomy (complicated by postoperative sciatic neurapraxia) to a total hip replacement in a cat.

作者信息

Liska W D, Doyle N D, Schwartz Z

机构信息

Gulf Coast Veterinary Specialists, Surgery, 1111 West Loop South, Suite # 160, Houston, Texas 77027, USA.

出版信息

Vet Comp Orthop Traumatol. 2010;23(2):119-23. doi: 10.3415/VCOT-09-07-0075. Epub 2010 Feb 11.

Abstract

A three-year-old neutered male Domestic Medium Hair cat was referred for evaluation of a right hindlimb monoparesis of one month duration following a femoral head ostectomy (FHO) performed elsewhere. Examination of the limb revealed muscle atrophy and decreased sensory perception over the sciatic nerve distribution with conscious proprioception and postural reaction deficits. The tentative diagnosis was sciatic neurapraxia. Radiographs taken prior to the FHO revealed a chronic nonunion right femoral neck fracture. The FHO was performed to remove the remnant of the femoral head and neck remaining in the acetabulum. Surgery was performed to explore the sciatic nerve and to revise the FHO into a total hip replacement. Sciatic nerve entrapment was present. Tethering sutures and extensive perineural adhesions were released to restore nerve gliding. Postoperatively, activity was limited for six weeks; normal activity resumed at eight weeks. Rehabilitation treatments were provided to maximise the patient's excellent recovery.

摘要

一只三岁已绝育的雄性家猫(中毛品种)因右后肢单瘫前来就诊,该症状持续了一个月,此次单瘫发生在其他地方进行股骨头切除术后(FHO)。对该肢体进行检查发现,坐骨神经分布区域存在肌肉萎缩,感觉减退,同时伴有本体感觉和姿势反应缺陷。初步诊断为坐骨神经失用症。在进行股骨头切除术之前拍摄的X光片显示,右侧股骨颈存在慢性不愈合骨折。进行股骨头切除术的目的是切除髋臼中残留的股骨头和股骨颈。随后进行了手术,探查坐骨神经,并将股骨头切除术改为全髋关节置换术。术中发现存在坐骨神经卡压。松解了束缚缝线和广泛的神经周围粘连,以恢复神经滑动。术后,六周内限制活动;八周后恢复正常活动。为使患者获得良好恢复,还提供了康复治疗。

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