Sciatic Nerve Injury in Total Hip Arthroplasty / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The study of the causative factors, surgical approachs and the clinical course of symptoms related to sciatic nerve injury after THR. MATERIAL AND METHODS: A retrospective review of 6 patients with sciatic nerve injury in 669 hips total hip arthroplasty during the period from Jan., 1986 to Dec., 1994. Each patient's record was reviewed with respect to age, sex, possible etiology, clinical course, surgical approach, treatment, and clinical condition at follow-up examination. RESULTS: ➀ The increased prevalence of nerve palsy was seen in revision surgeries(4 cases, 3.2%) compared to primary arthroplasty(2 cases, 0.4%) ➁ There was 2 cases(0.8%) of sciatic nerve injury in direct lateral approach and posterior approach, 4 cases(1%) ➂ Possible mechanisms of nerve injury included excessive soft tissue traction(3 cases), electrical thermal injury(1 case), Trochanteric fracture during femoral stem removal(1 case), and overlengthening of femur(1 case). ➃ The isolated peroneal division of the sciatic nerve was injured in 5 cases, and the both peroneal and tibial divisions were injured in one case. ➄ At a following period of 5 month, recovery of neurologic function was complete in con case, and two years follow up, 4 cases had a enough recovery of neurologic function(modified Sunderland scale 1,2). However, remained one case had a persistent severe weakness & dysesthesia at even 3 years follow-up. The prognosis for neurological recovery was related the degrees to which the nerve was damaged.