Document Detail


Postarthroplasty "palsy" and systemic neuropathy: a peripheral-nerve management algorithm.
MedLine Citation:
PMID:  16327467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Postarthroplasty palsy, occurrence of dysfunction of the sciatic or peroneal nerve after total joint replacement of the hip or knee, is a complication that remains poorly understood. Characteristics of a series of 24 patients with postarthroplasty palsy are reviewed, with the finding that, overall, 58.4% of the patients had an underlying peripheral neuropathy. The role of this neuropathy predisposing the arthroplasty patient to stretch/traction injury is discussed and should be emphasized as a risk factor prior to surgery and should influence the surgeon's intraoperative use of force during the arthroplasty procedure. This clinical problem is addressed from the perspective of peripheral nerve surgery, with an algorithm suggested for its management. The algorithm suggests that if a peroneal palsy is still present at 3 months after an arthroplasty and neurosensory testing fails to demonstrate a sensory reinnervation pattern in the territories of the deep or superficial peroneal nerve, then surgical neurolysis of the common peroneal nerve is indicated.
Authors:
A Lee Dellon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  55     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-03-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  638-42     Citation Subset:  IM    
Affiliation:
Johns Hopkins University, Baltimore, MD 21218, USA. aldellon@erols.com
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Arthroplasty, Replacement, Hip / adverse effects*
Arthroplasty, Replacement, Knee / adverse effects*
Decompression, Surgical
Humans
Peripheral Nervous System Diseases / diagnosis*,  etiology*,  physiopathology,  surgery
Peroneal Neuropathies / diagnosis,  etiology
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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