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[全髋关节置换术后神经损伤的预防、诊断与治疗]

[Avoidance, diagnostics and therapy of nerve lesions after total hip arthroplasty].

作者信息

Kirschner S, Goronzy J, Storch A, Günther K-P, Hartmann A

机构信息

Klinik und Poliklinik für Orthopädie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Deutschland.

出版信息

Orthopade. 2011 Jun;40(6):491-9. doi: 10.1007/s00132-011-1758-x.

Abstract

Nerve palsy following total hip arthroplasty is a rare complication. Developmental dysplasia of the hip, previous fracture treatment and medical comorbidities are characteristic risk factors. By accurate preparation of the patient and a careful operative technique nerve palsy can be avoided in most cases. Nerve palsy following poor patient positioning during the perioperative period should be avoided by close cooperation with anesthesiologists.In cases of postoperative nerve palsy correct diagnostics should be carried out immediately. Further treatment options should be considered to minimize the damage. For patients with definite nerve palsy, devices such as a foot drop splint are often necessary and should be carried out as soon as possible.

摘要

全髋关节置换术后的神经麻痹是一种罕见的并发症。髋关节发育不良、既往骨折治疗史和内科合并症是典型的危险因素。通过对患者进行准确的准备和采用精细的手术技术,大多数情况下可避免神经麻痹。围手术期患者体位不当导致的神经麻痹应通过与麻醉医生密切合作来避免。术后出现神经麻痹时,应立即进行正确的诊断。应考虑进一步的治疗方案以尽量减少损伤。对于确诊为神经麻痹的患者,通常需要尽快使用诸如垂足支具等装置。

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