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全髋关节置换术后脱位闭合复位后坐骨神经损伤

Laceration of the Sciatic Nerve After Closed Reduction of a Dislocated Total Hip Arthroplasty.

作者信息

Jolissaint Josef E, Posey Samuel L, Herndon Carl L, Wyles Cody C, Clair Andrew J, Fehring Thomas K

机构信息

Atrium Health-Musculoskeletal Institute, Charlotte, NC, USA.

OrthoCarolina-Hip & Knee Center, Charlotte, NC, USA.

出版信息

Arthroplast Today. 2023 Mar 7;20:101104. doi: 10.1016/j.artd.2023.101104. eCollection 2023 Apr.

Abstract

Sciatic nerve injury after closed reduction of a dislocated total hip arthroplasty (THA) is an exceedingly rare but tremendously devastating complication. Closed reduction is the standard of care and is typically associated with a low complication rate. There have only been seven sciatic nerve injuries after closed reduction of a dislocated THA reported in the literature, and none were secondary to nerve laceration. We report a case of sciatic nerve laceration after attempted closed reduction of a dislocated THA. This resulted in complete loss of sensory and motor sciatic nerve function. This case highlights the importance of a detailed neurologic examination before and after closed reduction of a dislocated total hip, the importance of using careful reduction maneuvers, and transitioning to open reduction when necessary.

摘要

全髋关节置换术(THA)脱位闭合复位后发生坐骨神经损伤是一种极其罕见但极具破坏性的并发症。闭合复位是治疗的标准方法,通常并发症发生率较低。文献中仅报道了7例全髋关节置换术脱位闭合复位后发生的坐骨神经损伤,且均非神经撕裂所致。我们报告了1例全髋关节置换术脱位尝试闭合复位后发生坐骨神经撕裂的病例。这导致坐骨神经感觉和运动功能完全丧失。该病例强调了全髋关节脱位闭合复位前后进行详细神经学检查的重要性、采用谨慎复位手法的重要性以及在必要时转为切开复位的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5350/10015181/0986a88f325d/gr1.jpg

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