Moore Abigail E, Stringer Mark D
Department of Anatomy, Otago School of Medical Sciences, University of Otago, PO Box 913, Dunedin, New Zealand.
Surg Radiol Anat. 2011 Oct;33(8):649-58. doi: 10.1007/s00276-011-0791-0. Epub 2011 Feb 17.
Iatrogenic femoral nerve injury is a recognized complication of abdominal and pelvic surgery. It causes distress and disability and may lead to permanent motor and/or sensory sequelae. The aim of this systematic review was to explore the contemporary spectrum of this injury reported in the literature.
A systematic review of iatrogenic femoral nerve injuries reported between 2000 and October 2010 was undertaken using the electronic databases Medline, PubMed, Cochrane Library, and Google Scholar. The context, frequency, mechanism of injury, and outcome were recorded. Relevant clinical and anatomical literature was reviewed to provide an overview of the surgical anatomy.
Iatrogenic femoral nerve injury is not rare, occurring as a complication of common abdominal, pelvic, and orthopedic operations and after femoral nerve blocks and femoral artery puncture. Mechanisms of injury are diverse and include direct trauma and ischemia from retraction or stretching of the nerve. Variant anatomy is very rarely the source of the problem. Although the prognosis in most cases is good some affected patients require nerve repair or grafting and some are left with permanent residual neurologic deficits.
A wider awareness of this complication, particularly the context in which it may occur, together with an appropriate understanding of the anatomy of the femoral nerve may help to reduce the frequency of this distressing and disabling iatrogenic complication.
医源性股神经损伤是腹部和盆腔手术中一种公认的并发症。它会引起痛苦和功能障碍，并可能导致永久性运动和/或感觉后遗症。本系统评价的目的是探讨文献中报道的这种损伤的当代情况。
使用电子数据库Medline、PubMed、Cochrane图书馆和谷歌学术对2000年至2010年10月期间报道的医源性股神经损伤进行系统评价。记录其背景、发生率、损伤机制和结果。查阅相关临床和解剖学文献以概述手术解剖结构。
医源性股神经损伤并不罕见，常见于腹部、盆腔和骨科的常见手术以及股神经阻滞和股动脉穿刺之后。损伤机制多种多样，包括神经牵拉或拉伸导致的直接创伤和缺血。解剖变异很少是问题的根源。虽然大多数情况下预后良好，但一些受影响的患者需要神经修复或移植，还有一些患者会留下永久性神经功能缺损。
对这种并发症有更广泛的认识，特别是其可能发生的背景，同时对股神经解剖结构有适当的了解，可能有助于减少这种令人痛苦和致残的医源性并发症的发生率。
