Hemorrhagic neuropathy of the sciatic, femoral and obturator nerves: case report and review of the literature.

A 70-year-old female developed hemorragic neuropathy, involving the sciatic, femoral and obturator nerves, secondary to infection and trauma. Function returned adequately in one year in the manner of neuropraxia. Hemorrhagic neuropathy of the proximal lower extremity has been associated with hemophilia, anticoagulation therapy, trauma, hip surgery and bleeding arteriosclerotic disease of the distal aorta and iliac vessels. The majority of cases regain function in 1 year using conservative therapy.

Epineurial and perineurial fascicular nerve repairs: a critical comparison.

To compare the results of epineurial and intrafascicular perineurial nerve repair techniques, ulnar nerves of 20 domestic cats were severed proximal to the medical humeral epicondyle. One nerve was repaired with No.8-O nylon by standard epineurial technique with the aid of three to five magnifications; the other nerve was repaired with No. 10-O nylon by intrafascicular perineurial technique under higher magnification. Four to five months following neurorrhaphies, the ambulation pattern, fanning of claws, and sensation were evaluated subjectively. Objective measurements included efficiency, absolute strength, and exact weight of the flexor carpi ulnaris muscle. Proximally and distally to each neurorrhaphy, complete axon counts were taken. Histochemically and histologic analyses were made on reinnervated muscles and neuromas. No statistically significant differences were detected between the results of epineurial and intrafascicular perineurial neurorrhaphies. These findings indicate that, following acute nerve laceration in the cat, epineurial neurorrhaphy is as satisfactory as is intrafascicular perineurial neurorrhaphy.

Posterior bone-grafting for infected ununited fracture of the tibia.

Twenty-three patients with severe open tibial fractures complicated by established deep infection and delay or failure of union were treated with posterior tibial bone-grafting. This was followed by immediate ambulation in a plaster cast. Tibial union was achieved in all twenty-three patients. Drainage ceased prior to or simultaneously with union in twenty-one patients, including twelve of fourteen patients who had indolent drainage from the anterior compartment of the leg at the time of posterior tibial bone-grafting.