PDF(Pubmed)
Abstract：
BACKGROUND: While sciatic nerve injury has been described as a complication of acetabular fractures, iatrogenic nerve injury remains sparsely reported. This study aims to assess iatrogenic sciatic nerve injuries occurring during acetabular fracture surgery, tracking their neurological recovery and clinical outcomes, and investigating any correlation between recovery and the severity of neurologic injury to facilitate physicians in providing prediction of prognosis.
METHODS: We present two cases of male patients, aged 56 and 22, who developed sciatic palsy due to iatrogenic nerve injury during acetabular fracture surgery. Iatrogenic sciatic nerve injury resulted from operatively treated acetabular fractures. Surgical exploration, involving internal fixation removal and nerve decompression, successfully alleviated symptoms in both cases postoperatively. At the latest follow-up, one patient achieved full recovery with excellent function, while the other exhibited residual deficits at the L5/S1 root level along with minimal pain.
CONCLUSIONS: Sciatic nerve injury likely stemmed from reduction techniques and internal fixation procedures for the posterior column, particularly when performed with the hip flexed, thereby placing tension on the sciatic nerve. Our case reports underscore the significance of liberal utilization of electrophysiologic examinations and intraoperative monitoring for the prediction of prognosis. Surgical exploration, encompassing internal fixation removal and nerve decompression, represents an effective intervention for resolving sciatic palsy, encompassing both sensory neuropathy and motor symptoms.
METHODS: We present two cases of male patients, aged 56 and 22, who developed sciatic palsy due to iatrogenic nerve injury during acetabular fracture surgery. Iatrogenic sciatic nerve injury resulted from operatively treated acetabular fractures. Surgical exploration, involving internal fixation removal and nerve decompression, successfully alleviated symptoms in both cases postoperatively. At the latest follow-up, one patient achieved full recovery with excellent function, while the other exhibited residual deficits at the L5/S1 root level along with minimal pain.
CONCLUSIONS: Sciatic nerve injury likely stemmed from reduction techniques and internal fixation procedures for the posterior column, particularly when performed with the hip flexed, thereby placing tension on the sciatic nerve. Our case reports underscore the significance of liberal utilization of electrophysiologic examinations and intraoperative monitoring for the prediction of prognosis. Surgical exploration, encompassing internal fixation removal and nerve decompression, represents an effective intervention for resolving sciatic palsy, encompassing both sensory neuropathy and motor symptoms.
摘要：
背景：虽然坐骨神经损伤被描述为髋臼骨折的并发症，医源性神经损伤的报道仍然很少。本研究旨在评估髋臼骨折手术中发生的医源性坐骨神经损伤，跟踪他们的神经恢复和临床结果，并研究恢复与神经损伤严重程度之间的任何相关性，以帮助医生提供预后预测。
方法：我们介绍了2例男性患者，年龄分别为56岁和22岁，在髋臼骨折手术中因医源性神经损伤而出现坐骨神经麻痹。手术治疗的髋臼骨折导致医源性坐骨神经损伤。手术探查,包括内固定摘除和神经减压，术后均成功缓解症状。在最新的后续行动中，一名患者完全康复，功能出色，而另一个在L5/S1根部水平表现出残留缺陷，并且疼痛最小。
结论：坐骨神经损伤可能源于后柱复位技术和内固定手术，特别是当臀部弯曲时，从而在坐骨神经上施加张力。我们的病例报告强调了合理利用电生理检查和术中监测对预测预后的重要性。手术探查,包括内固定移除和神经减压，代表解决坐骨神经麻痹的有效干预措施，包括感觉神经病变和运动症状。
方法：我们介绍了2例男性患者，年龄分别为56岁和22岁，在髋臼骨折手术中因医源性神经损伤而出现坐骨神经麻痹。手术治疗的髋臼骨折导致医源性坐骨神经损伤。手术探查,包括内固定摘除和神经减压，术后均成功缓解症状。在最新的后续行动中，一名患者完全康复，功能出色，而另一个在L5/S1根部水平表现出残留缺陷，并且疼痛最小。
结论：坐骨神经损伤可能源于后柱复位技术和内固定手术，特别是当臀部弯曲时，从而在坐骨神经上施加张力。我们的病例报告强调了合理利用电生理检查和术中监测对预测预后的重要性。手术探查,包括内固定移除和神经减压，代表解决坐骨神经麻痹的有效干预措施，包括感觉神经病变和运动症状。
