Document Detail


Sciatic nerve entrapment secondary to trochanteric wiring following total hip arthroplasty. A case report.
MedLine Citation:
PMID:  6627788     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In an 81-year-old woman the sciatic nerve was inadvertently penetrated with the trochanteric wire and incorporated into the trochanteric wiring during trochanteric attachment in total hip arthroplasty through a transtrochanteric approach. Immediately after operation, the patient had a sciatic palsy. Exploration of the wound revealed that the nerve had been entrapped in the trochanteric wiring mechanism. Despite release of the nerve and neurolysis, symptoms persisted, and the patient had a complete sciatic palsy that has not recovered. The technical aspects of total hip arthroplasty utilizing trochanteric osteotomy should include internal rotation of the femur during insertion of trochanteric wire so that the posterior aspects of the hip joint and the femoral shaft can be fully observed. Similarly, all wire should be free of any soft tissue prior to twisting and tightening. Patients awakening with profound and immediate sciatic involvement should be explored early to determine the cause as well as to alleviate any possible impingement that might interfere with the prognosis of this very serious injury.
Authors:
T H Mallory
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  1983 Nov 
Date Detail:
Created Date:  1983-12-17     Completed Date:  1983-12-17     Revised Date:  2005-03-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  198-200     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Femur / surgery
Hip Prosthesis / adverse effects*
Humans
Nerve Compression Syndromes / etiology*,  pathology
Osteotomy / adverse effects,  instrumentation
Sciatic Nerve / injuries*

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


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