Applied anatomy of the sciatic nerve injury in the artificial total hip arthroplasty

Jingwu YANG; Xiaolin SHI

ABSTRACT

BACKGROUND:

At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.

OBJECTIVE:

To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.

DESIGN:

Single sample study based on the human anatomical samples.

SETTING:

Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.

PARTICIPANTS:

The study was completed in the Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.

METHODS:

The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME

MEASURES:

The location relation of the sciatic nerve and the acetabulum.

RESULTS:

The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.

CONCLUSION:

It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.