Service de chirurgie orthopédique, hôpital Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France.
Orthop Traumatol Surg Res. 2013 Nov;99(7):785-90. doi: 10.1016/j.otsr.2013.07.015. Epub 2013 Sep 28.
Pudendal nerve neurapraxia is a classic complication after traction on the fracture table. Diagnosis, however, is difficult and often overlooked, especially after arthroscopy in traction on fracture table; incidence is therefore not known exactly.
The study hypothesis was that incidence of pudendal nerve neuropathy exceeds 1% after hip arthroscopy.
Results for 150 patients (79 female, 71 male) undergoing hip arthroscopy between 2000 and 2010 were analyzed retrospectively. The principal assessment criterion was onset of pudendal neuralgia. Secondary criteria were risk factors (history, surgery time, type of anesthesia), associated complications, onset to diagnosis interval and pattern of evolution.
At a mean 93 months' follow-up, there were 3 cases (2 women, 1 man) (2%) of pure sensory pudendal neuralgia; 2 concerned labral lesion resection and 1 osteochondromatosis. Surgery time ranged from 60 to 120min, under general anesthesia with curarization. Time to diagnosis was 3 weeks. No complementary examinations were performed. Spontaneous resolution occurred at 3 weeks to 6 months. No significant risk factors emerged.
The present study found 2% incidence of pudendal neuralgia, with no risk factors emerging from analysis. Prevention involves limiting traction force and duration by using a large pelvic support (diameter>8-10cm). Patient information and postoperative screening should be systematic.
Level IV. Retrospective study.
阴部神经麻痹是牵引骨折台上骨折时的经典并发症。然而，其诊断困难，经常被忽视，尤其是在牵引骨折台上关节镜检查后；因此，确切的发病率尚不清楚。
本研究的假设是，髋关节镜检查后阴部神经病变的发病率超过 1%。
回顾性分析了 2000 年至 2010 年间接受髋关节镜检查的 150 例患者（79 例女性，71 例男性）的结果。主要评估标准为阴部神经痛的发作。次要标准为危险因素（病史、手术时间、麻醉类型）、相关并发症、发病至诊断间隔和演变模式。
在平均 93 个月的随访中，有 3 例（2 例女性，1 例男性）（2%）出现单纯感觉性阴部神经痛；2 例与盂唇病变切除术有关，1 例与软骨瘤病有关。手术时间为 60 至 120 分钟，全身麻醉下使用肌松剂。诊断时间为 3 周。未进行其他补充检查。自发性缓解发生在 3 周到 6 个月之间。未出现明显的危险因素。
本研究发现阴部神经痛的发病率为 2%，分析未发现明显的危险因素。预防措施包括使用大骨盆支撑物（直径>8-10cm）来限制牵引力和时间。应系统地对患者进行信息和术后筛查。
IV 级，回顾性研究。
