Goldet R, Kerdraon J, Amarenco G
Service de Médecine Physique et de Réadaptation, HIA Percy, Clamart.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Oct;84(6):523-30.
We performed a retrospective study about perioperative pudendal nerve palsy following fracture table tractions.
Six palsies were investigated. Mean age was 26 years. All of them presented sensitive and motor dysfunctions secondary to nerve compression following tractions on the fracture table.
All of them had complete electrophysiological recordings including perineal electromyogram, measurement of sacral roots latencies, sensory velocity of the dorsal nerve of the penis, somatosensory evoked potentials of the pudendal nerve and measurement of its terminal branches.
Neurological symptoms were stereotyped associating sensory signs and sexual disorders, must of them being transient. Perineal electrophysiological examination always confirmed reality of pudendal nerve palsy.
We discuss incidence, mechanism, etiology and prevention of this pudendal nerve palsy.
Emergence of stereotyped perineal symptoms following orthopaedic surgery, especially after tractions on fracture table, must prevail on physicians to search for pudendal nerve palsy. Usual outcome is good in the six months following surgery, but definitive aftermath does occur. Perineal electrophysiological examination can confirm pudendal nerve palsy and give prognosis elements.
我们对骨折手术台牵引后围手术期阴部神经麻痹进行了一项回顾性研究。
对6例麻痹病例进行了调查。平均年龄为26岁。所有病例均表现为骨折手术台牵引后神经受压继发的感觉和运动功能障碍。
所有病例均进行了完整的电生理记录，包括会阴肌电图、骶神经根潜伏期测量、阴茎背神经感觉速度、阴部神经体感诱发电位及其终末支测量。
神经症状表现为感觉体征和性功能障碍相关的刻板症状，大多数为短暂性。会阴电生理检查始终证实阴部神经麻痹的存在。
我们讨论了这种阴部神经麻痹的发生率、机制、病因及预防。
骨科手术后，尤其是骨折手术台牵引后出现刻板的会阴症状，应促使医生排查阴部神经麻痹。术后6个月内通常预后良好，但确实会出现远期后遗症。会阴电生理检查可证实阴部神经麻痹并提供预后依据。
