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Femoral nerve palsy

John A Abraham, Barry Kenneally, Kamil Amer, David S Geller
BACKGROUND: Navigation-assisted resection has been proposed as a useful adjunct to resection of malignant tumors in difficult anatomic sites such as the pelvis and sacrum where it is difficult to achieve tumor-free margins. Most of these studies are case reports or small case series, but these reports have been extremely promising. Very few reports, however, have documented benefits of navigation-assisted resection in series of pelvic and sacral primary tumors. Because this technology may add time and expense to the surgical procedure, it is important to determine whether navigation provides any such benefits or simply adds cost and time to an already complex procedure...
March 2018: Clinical Orthopaedics and related Research
Kalpana Babu, Deepika C Parameswarappa
Purpose: We report an interesting case of atypical Tolosa Hunt syndrome with bilateral Sclerokeratitis and optic atrophy in a patient with Takayasu's arteritis. Observations: A 31-year- old lady presented with severe retroorbital pain in the right eye and right sided headache of 2 weeks duration. She had a history of 6th and 7th nerve palsies which improved with oral corticosteroids. Her BCVA was no perception of light in OD and 6/6 in OS. Slitlamp examination showed bilateral old sclerokeratitis and fundus examination showed bilateral optic atrophy...
April 2017: American Journal of Ophthalmology Case Reports
Zoe B Cheung, Anik V Patel, Nicholas DeBellis, Douglas B Unis, Carlos L Benitez
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...
January 10, 2018: JBJS Case Connector
Ronald E Delanois, Assem A Sultan, Ahmed A Albayar, Anton Khlopas, Chukwuweike U Gwam, Nipun Sodhi, Suela Lamaj, Jared M Newman, Michael A Mont
Background: Multiple approaches to the hip joint have been developed utilizing various intervals and/or intermuscular planes when performing a total hip arthroplasty (THA), each proposing certain advantages. Of these, the Röttinger approach (modified anterolateral or Watson-Jones) is potentially muscle-sparing. Multiple studies have demonstrated favorable outcomes with this approach. However, others showed more complications with a slow learning curve. Due to the paucity of evidence we conducted this study to: (I) present our operative experience and technique of the Röttinger approach; (II) compare short-term complications and operative room (OR) times of this approach to the direct lateral; and (III) review the available literature...
December 2017: Annals of Translational Medicine
Yasuko Nakamura, Hiroshi Matsumoto, Kiyotaka Zaha, Kenji Uematsu, Shigeaki Nonoyama
BACKGROUND: A heterozygous c.1228G > A p.E410K mutation in TUBB3 encoding neuronal-specific β-tubulin isotype 3 causes TUBB3 E410K syndrome, which exhibits a wide range of neurological and endocrinological abnormalities. CASE DESCRIPTION: The patient is a 31-year-old Japanese woman who was diagnosed with atypical Moebius syndrome because of congenital facial weakness and extraocular ophthalmoplegia sparing abduction. She suffered a femoral neck fracture at 23 years of age, and radiological and endocrinological studies revealed osteoporosis because of hypogonadotropic hypogonadism...
December 27, 2017: Brain & Development
L Andreani, A M Nucci, M Giuntoli, M Lisanti
Introduction: Femoral nerve compression caused by iliopsoas hematoma is a rare complication after hip surgery. To the best of our knowledge, this is the first case after hemiarthroplasty. In this case, iliacus hematoma resulted from spontaneous bleeding favored by anticoagulant therapy. Case Report: A 78-year-old female developed left groin pain associated with typical symptoms of femoral nerve palsy about 2weeks after left hip hemiarthroplasty[1, 2, 3]. Computed tomography revealed the presence of a left iliopsoas hematoma that was surgically drained...
September 2017: Journal of Orthopaedic Case Reports
Andrew N Fleischman, Richard H Rothman, Javad Parvizi
BACKGROUND: Femoral nerve palsy (FNP) is a relatively uncommon complication following total hip arthroplasty (THA). There is little recent literature regarding the incidence of FNP and the natural course of recovery. METHODS: Using our institutional database, we identified postoperative FNPs from 17,350 consecutive primary THAs performed from 2011 to 2016. Hip exposures were performed using a direct lateral (modified Hardinge), direct anterior (Smith-Peterson), anterolateral (Watson-Jones), or posterolateral (Southern or Moore) approach...
November 4, 2017: Journal of Arthroplasty
Osman Nawazish Salaria, Murlikrishna Kannan, Bryan Kerner, Howard Goldman
The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.
2017: Case Reports in Anesthesiology
Jing Hui Yik, Bryan Thean Howe Koh, Wilson Wang
BACKGROUND: Bucket-handle meniscus tears (BHMT) are often displaced and unstable. The inside-out technique of repairing such tears is currently the gold standard. All-inside repair with meniscal fixators is getting increasingly popular. Shortcomings of the inside-out technique include neurovascular complications, especially saphenous nerve palsy, and retention of a non-resorbable suture which can result in discomfort to patient, granuloma formation, and a foci of infection. Hence, the purpose of this project was to innovate a novel all-inside technique to precisely reduce and fix BHMT while avoiding neurovascular complications and retention of a non-resorbable suture...
December 4, 2017: Journal of Orthopaedic Surgery and Research
Ishaan Swarup, Caitlin L Penny, Emily R Dodwell
PURPOSE OF REVIEW: Our understanding of the epidemiology, diagnosis, and management of developmental dysplasia of the hip (DDH) is evolving. This review focuses on the most up-to-date literature on DDH in patients from birth to six months of age. RECENT FINDINGS: Well known risk factors for DDH include family history, female sex, and breech positioning. Recent evidence suggests higher birth weight is a risk, whereas prematurity may be protective. Screening includes physical examination of all infant hips and imaging when abnormal findings or risk factors are present...
February 2018: Current Opinion in Pediatrics
Chun Bi, Qiugen Wang, Jianhong Wu, Feng Zhou, Fei Zhang, Haipeng Liang, Fei Lyu, Jiandong Wang
BACKGROUND: Anterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture. METHODS: Either modified pedicle screw-rod fixation (modified PSRF group, N = 21) or anterior pelvic external fixation (APEF group, N = 22) was performed to 43 patients, with or without fixation of posterior ring...
December 1, 2017: Journal of Orthopaedic Surgery and Research
Duan Wang, De-Hua Li, Qi Li, Hao-Yang Wang, Ze-Yu Luo, Yang Yang, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: This retrospective study was designed to determine complications, functional and radiographic results of transverse subtrochanteric osteotomy during cementless, modular total hip arthroplasty (THA) in a series of active patients younger than 45 years with Crowe Type-III or IV developmental dysplasia of the hip (DDH). METHODS: We followed 49 patients (56 hips) with DDH who were treated with cementless THA, where the acetabular cup was positioned in the anatomic hip center and where a simultaneous transverse femoral osteotomy was performed...
November 25, 2017: BMC Musculoskeletal Disorders
Amy M Moore, Emily M Krauss, Rajiv P Parikh, Michael J Franco, Thomas H Tung
Sciatic nerve injuries cause debilitating functional impairment, particularly when the injury mechanism and level preclude reconstruction with primary grafting. The purpose of this study was to demonstrate the anatomical feasibility of nerve transfers from the distal femoral nerve terminal branches to the tibial nerve and to detail the successful restoration of tibial function using the described nerve transfers. Six cadaveric legs were dissected for anatomical analysis and the development of tension-free nerve transfers from femoral nerve branches to the tibial nerve...
November 3, 2017: Journal of Neurosurgery
Shai S Shemesh, Jonathan Robinson, Samuel Overley, Michael J Bronson, Calin S Moucha, Darwin Chen
INTRODUCTION: Sciatic nerve injury (SNI) is a potentially devastating complication after total hip arthroplasty (THA). Intraoperative neural monitoring has been found in several studies to be useful in preventing SNI, but can be difficult to implement. In this study, we examine the results of using a handheld nerve stimulator for intraoperative sciatic nerve (SN) monitoring during complex THA requiring limb lengthening and/or significant manipulation of the SN. METHODS: A consecutive series of 11 cases (9 patients, 11 hips) with either severe developmental dysplasia of the hip (Crowe 3-4) or other underlying conditions requiring complex hip reconstruction involving significant leg lengthening and/or nerve manipulation...
October 9, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jacob M Conjeski, Giles R Scuderi
BACKGROUND: Multiple surgical techniques exist to restore limb alignment and to balance soft tissues in valgus knees during total knee arthroplasty (TKA). One technique is to perform a lateral femoral epicondylar osteotomy. METHODS: A retrospective analysis was performed on all patients with a fixed valgus deformity that was corrected with a lateral femoral epicondylar osteotomy during TKA. Preoperative and postoperative Knee Society Knee Scores, knee stability, range of motion, and radiographic alignment were recorded...
September 19, 2017: Journal of Arthroplasty
Ari J Holtzman, Christopher D Glezos, Eric J Feit, Konrad I Gruson
PURPOSE: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development. METHODS: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mantu Jain, Saurav Narayan Nanda, Soumya Shrikanta Mohapatra, Barada Prasanna Samal
Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator...
August 2017: Journal of Clinical Orthopaedics and Trauma
X Zhou, W Lv, W Zhang, Y Ye, Y Li, Q Zhou, J Zhang, Q Xing, Y Lu, L Zhang, H Wang, W Qin, B Tang
This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generation cryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using a CF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group compared with that in the CF group [mean difference (MD)=29...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
D Gaut, B D Cone, A L Gregson, V G Agopian
Mucormycosis has emerged as a major threat to transplant recipients with high morbidity and mortality. This infection most commonly presents with rhino-sino-orbital localization. Gastrointestinal mucormycosis is uncommon, with presenting symptoms usually abdominal in nature. Here, we describe the case of a liver transplant recipient who developed gastrointestinal mucormycosis with an initial manifestation of femoral nerve palsy, ultimately resulting in fungal dissemination and patient demise. This case highlights the challenges in making a timely diagnosis of mucormycosis, particularly in immunocompromised patients...
July 26, 2017: Transplantation Proceedings
Giuseppe Rollo, Giuseppe Solarino, Giovanni Vicenti, Girolamo Picca, Massimiliano Carrozzo, Biagio Moretti
BACKGROUND: Total hip replacement for high dislocation of the hip presents some difficulties, considering patients' young ages, the abnormal hip anatomy and the high rate of complications. In this study, we present our experience in terms of clinical and radiological results in the treatment of Crowe type IV hips with subtrochanteric femoral shortening osteotomy and cementless total hip replacement. MATERIALS AND METHODS: We retrospectively reviewed 15 patients with Crowe type IV hip dysplasia (two bilateral cases for a total of 17 hips) treated with cementless total hip replacement associated with shortening subtrochanteric osteotomies (nine transversal and eight Z-shape osteotomies) between March 2000 to February 2006...
December 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
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