Magu Narender Kumar, Gogna Paritosh, Magu Sarita, Lohchab Ss
Department of Orthopaedics, Paraplegia and Rehabilitation, PGIMS, Rohtak, Haryana, India.
Department of Radiodiagnosis, PGIMS, Rohtak, Haryana, India.
Indian J Orthop. 2015 Jan-Feb;49(1):114-6. doi: 10.4103/0019-5413.143922.
We report a case of ischemic neuropathy of the sciatic nerve in a patient with an anterior column fracture of the acetabulum operated by ilioinguinal approach. It resulted from occlusion of the blood supply to the sciatic nerve. There were no signs of a vascular insult until ischemic changes ensued on the 6(th) postoperative day on the lateral part of great toe. The patient underwent crossover femoro-femoral bypass grafting and there was a complete reversal of the ischemic changes at 6 months. The sciatic nerve palsy continued to recover until the end of 1 year; by which time the only deficit was a Grade 4 power in the extensor hallucis longus (EHL) and the extensor digitorum longus (EDL). There was no further recovery at 2 years followup.
我们报告了1例髋臼前柱骨折患者，采用髂腹股沟入路手术，术后出现坐骨神经缺血性神经病变。其病因是坐骨神经血供受阻。术后第6天，在拇趾外侧出现缺血改变之前，没有血管损伤的迹象。患者接受了交叉股-股旁路移植术，6个月时缺血改变完全逆转。坐骨神经麻痹持续恢复至1年末；此时唯一的功能障碍是拇长伸肌（EHL）和趾长伸肌（EDL）肌力为4级。在2年的随访中没有进一步恢复。
