全髋关节置换假体脱位闭合复位过程中坐骨神经在股骨假体周围的缠绕：金属抑制磁共振成像的作用：一例报告
Sciatic Nerve Entanglement Around a Femoral Prosthesis During Closed Reduction of a Dislocated Total Hip Prosthesis: The Role of Metal-Suppression MRI: A Case Report.
作者信息
Cheung Zoe B, Patel Anik V, DeBellis Nicholas, Unis Douglas B, Benitez Carlos L
机构信息
Departments of Orthopaedic Surgery (Z.B.C., N.D., and D.B.U.) and Radiology (A.V.P. and C.L.B.), Mount Sinai West, New York, NY.
出版信息
JBJS Case Connect. 2018 Jan-Mar;8(1):e3. doi: 10.2106/JBJS.CC.17.00105.
CASE
A 68-year-old woman who had undergone a right total hip arthroplasty presented with a right posterior hip dislocation, and subsequently developed an ipsilateral sciatic nerve palsy after closed reduction. Magnetic resonance imaging (MRI) with metal suppression demonstrated sciatic nerve entanglement around the prosthetic femoral neck. A sciatic nerve release was performed, resulting in poor early neurologic recovery.
CONCLUSION
Sciatic nerve entanglement following closed reduction of a dislocated total hip prosthesis is a rare injury. Assessment of neurovascular status before and after reduction is imperative. We recommend prompt MRI with metal suppression in patients with acute neurologic symptoms following reduction of a dislocated hip prosthesis to evaluate for acute nerve pathology and assess the need for emergency surgery.
病例
一名68岁女性，曾接受右侧全髋关节置换术，现出现右髋关节后脱位，在闭合复位后继而出现同侧坐骨神经麻痹。金属抑制磁共振成像（MRI）显示坐骨神经在人工股骨颈周围缠绕。进行了坐骨神经松解术，但早期神经恢复不佳。
结论
全髋关节置换假体脱位闭合复位后出现坐骨神经缠绕是一种罕见的损伤。复位前后评估神经血管状况至关重要。对于髋关节置换假体复位后出现急性神经症状的患者，我们建议迅速进行金属抑制MRI检查，以评估急性神经病变并确定是否需要急诊手术。
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