Asopa Vipin, Al-Nammari Shafic, Spriggins Tony, Menz Tony, Bauze Adrian
Sportsmed.SA, 32 Payneham Road, Stepney, Adelaide, SA 5069, Australia.
Case Rep Orthop. 2014;2014:810481. doi: 10.1155/2014/810481. Epub 2014 Dec 17.
The occurrence of sciatic nerve palsy following posterior and anterolateral approaches to the hip has been well documented and is about 1-2%. To our knowledge, however, there are no reports of sciatic nerve palsy occurring secondary to the anterior approach to the hip for arthroplasty. We describe a case of sciatic nerve palsy secondary to haematoma formation following total hip replacement through the anterior approach. The recommencement of warfarin for prophylaxis against atrial fibrillation is thought to have been a contributing factor. Full recovery is rare following delayed diagnosis and early recognition of the signs of pain, parasthesia, and gradual loss of dorsiflexion and prompt drainage may reverse the condition. We advise caution with restarting warfarin following total hip arthroplasty.
髋关节后外侧和前外侧入路术后发生坐骨神经麻痹已有充分文献记载，发生率约为1% - 2%。然而，据我们所知，尚无因髋关节置换前路手术继发坐骨神经麻痹的报道。我们描述了一例通过前路全髋关节置换术后因血肿形成继发坐骨神经麻痹的病例。重新开始使用华法林预防心房颤动被认为是一个促成因素。延迟诊断后很少能完全恢复，早期识别疼痛、感觉异常以及背屈逐渐丧失的体征并及时引流可能会使病情逆转。我们建议全髋关节置换术后重新使用华法林时要谨慎。
