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双极半髋关节置换术后抗凝治疗继发伤口血肿导致的迟发性坐骨神经麻痹——一种罕见并发症:病例报告

Delayed Onset Sciatic Nerve Palsy Secondary to Wound Hematoma following Anticoagulant Therapy Post-Bipolar Hemiarthroplasty - an Uncommon Complication: A Case Report.

作者信息

Balaji G, Sriharsha Y, Sharma D

机构信息

Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.

出版信息

Malays Orthop J. 2019 Jul;13(2):49-51. doi: 10.5704/MOJ.1907.010.

Abstract

A 58-year old female patient presented to us with a three months' old fracture of the neck of femur. She underwent bipolar hemiarthroplasty. In the immediate postoperative period, she developed deep vein thrombosis for which she was started on anticoagulant therapy. Patient had persistent discharge from the wound since then and underwent regular dressings. On the eighth post-op day, she developed sciatic nerve palsy secondary to wound haematoma. The haematoma was decompressed immediately and she had a dramatic improvement in pain but her neurological deficit persisted. The wound healed completely without any complications. At three months follow up, she had recovered completely with grade 5/5 power in ankle and foot and full sensory recovery in the sciatic nerve distribution. She was ambulating comfortably with a walker. At final follow up around 20 months post-operation, she was pain-free and walking without any support. The wound had healed completely.

摘要

一名58岁女性患者因股骨颈骨折三个月前来就诊。她接受了双极半髋关节置换术。术后即刻,她发生了深静脉血栓形成,为此开始接受抗凝治疗。从那时起,患者伤口持续有分泌物,并接受了定期换药。术后第八天,她因伤口血肿继发坐骨神经麻痹。血肿立即得到减压,她的疼痛有了显著改善,但神经功能缺损仍然存在。伤口完全愈合,没有任何并发症。在术后三个月的随访中,她已完全康复,踝关节和足部肌力为5/5级,坐骨神经分布区域感觉完全恢复。她使用助行器行走自如。在术后约20个月的最终随访中,她没有疼痛,无需任何支撑即可行走。伤口已完全愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12c0/6702974/8862d088f5ad/moj-13-049-f1.jpg

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