Acta Chir Orthop Traumatol Cech. 2012; 79(5):437-441 | DOI: 10.55095/achot2012/062
Operační léčba poranění nervus ischiadicusPůvodní práce
- Neurochirurgická klinika 3. LF UK a FNKV, Praha 10
PURPOSE OF THE STUDY:
Injury to the sciatic nerve is a rare event. Apart from war time surgery, it usually presents as a closed lesion caused by traction. The aim of the study was to evaluate a group of patients treated for sciatic nerve injury, with an analysis of the cause for and the outcome of surgery.
MATERIAL AND METHODS:
In this prospective study, the results in ten patients treated surgically were evaluated. Five patients underwent exoneurolysis, two were treated by end-to-end suture of the nerve and three by suture and sural nerve grafting. One patient was lost to follow-up and nine were followed up for minimally 24 months after surgery.
RESULTS:
In the patients treated by exoneurolysis, sciatic nerve function recovered in the peroneal division in 60%, and in the tibial portion in 100% of them. The result depended mainly on the interval between injury and surgery. Of four patients with direct suture of the nerve or with sural nerve grafting, function of the tibial portion recovered in three (75%) and that of the peroneal portion in one (25%).
CONCLUSIONS:
Although the course of the sciatic nerve is very long, its surgical treatment is fully justified because it shows good results even in buttock-level and thigh-level nerve injuries.
Klíčová slova: sciatic nerve injury, reconstruction with nerve graft, neurolysis
Zveřejněno: 1. říjen 2012 Zobrazit citaci
Reference
- AUSTIN, M.S., KLEIN, G.R., SHARKEY, P.F., HOZACK, W.J., ROTHMAN, R.H.: Late sciatic nerve palsy caused by hematoma after primary total hip arthroplasty. J. Arthroplasty, 19: 790-792, 2004.
Přejít k původnímu zdroji...
Přejít na PubMed...
- DOU©A, P., BARTONÍČEK, J., PAVELKA, T., LUŇÁČEK, L.: Ipsilateral fractures of the proximal femur and the femoral shaft. Acta Chir. orthop. Traum. čech., 77: 378-388, 2010.
Přejít k původnímu zdroji...
- D®UPA, V., CHMELOVÁ, J., PAVELKA, T., OBRUBA, P., WENDSCHE, P., SIMKO, P., FILIPÍNSKÝ, J., KLOUB, M., PLEVA, L., KOPP, L., MALKUS, T., FRANK, M., MAGALA, M., LISÝ, M., ROVDER, P., DRÁČ, P., KŘIVOHLÁVEK, M., VI©ŇA, P.: Multicentric study of patients with pelvic injury: Basic analysis of the study group. Acta Chir. orthop. Traum. čech., 76: 404-409, 2009.
Přejít k původnímu zdroji...
- EHLER, E.: Lesion of the peripheral nerves caused by alloplastic surgery of the hip joint. Eurorehab., 2: 79-81, 1996.
- GAY, D.P., DESSER, D.R., PARKS, B.G., BOUCHER, H.R.: Sciatic nerve injury in total hip resurfacing: a biomechanical analysis. J. Arthroplasty, 25: 1295-1300, 2010.
Přejít k původnímu zdroji...
Přejít na PubMed...
- GOUSHEH, J., ARASTEH, E., BEIKPOUR, H.: Therapeutic results of sciatic nerve repair in Iran-Iraq war casualties. Plast. Reconstr. Surg., 121: 878-886, 2008.
Přejít k původnímu zdroji...
Přejít na PubMed...
- HURD, J.L., POTTER, H.G., DUA, V., RANAWAT, C.S.: Sciatic nerve palsy after primary total hip arthroplasty: a new perspective. J. Arthroplasty, 21: 796-802, 2006.
Přejít k původnímu zdroji...
Přejít na PubMed...
- ISSACK, P.S., HELFET, D.L.: Sciatic nerve injury associated with acetabular fractures. HSS J., 5: 12-18, 2009.
Přejít k původnímu zdroji...
Přejít na PubMed...
- KAISER, R., HOU©«AVA, L., MENCL, L., BRZEZNY, R., HANINEC, P.: Operační léčba poranění peroneálního nervu. Cesk. Slov. Neurol. N., 74/107: 187-190, 2011.
- KIM, D.H., MUROVIC, J.A., TIEL, R., KLINE, D.G.: Management and outcomes in 353 surgically treated sciatic nerve lesions. J. Neurosurg., 101: 8-17, 2004.
Přejít k původnímu zdroji...
Přejít na PubMed...
- MATEJČÍK, V.: Results of surgery in injuries of the ischiadic nerve and its branches. Cesk. Slov. Neurol. N., 65: 20-24, 2002.
- PATIL PG, FRIEDMAN A.H.: Surgical exposure of the sciatic nerve in the gluteal region: anatomic and historical comparison of two approaches. Neurosurgery, 561 (Suppl): 165-171, 2005.
Přejít k původnímu zdroji...
Přejít na PubMed...
- PEKKARINEN, J., ALHO, A., PUUSA, A., PAAVILAINEN, T.: Recovery of sciatic nerve injuries in association with total hip arthroplasty in 27 patients. J. Arthroplasty, 14: 305-311, 1999.
Přejít k původnímu zdroji...
Přejít na PubMed...
- POKORNÝ, D., SOSNA, A., VEIGL, P., JAHODA, D.: Anatomic variability of the relation of pelvitrochanteric muscles and sciatic nerve. Acta Chir. orthop. Traum. čech., 65: 336-339, 1998.
- POKORNÝ, D., JAHODA, D., VEIGL, D., PINSKEROVÁ, V., SOSNA, A.: Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surg. Radiol. Anat., 28: 88-91, 2006.
Přejít k původnímu zdroji...
Přejít na PubMed...
- SAMARD®IĆ, M.M., RASULIĆ, L.G., VUCKOVIĆ, C.D.: Missile injuries of the sciatic nerve. Injury, 30: 15-20, 1999.
Přejít k původnímu zdroji...
Přejít na PubMed...
- SEDDON, H.J.: Medical research council special report series. No. 282. London: Her Majesty's Stationery Office. Peripheral Nerve Injuries, 1954.
- SOSNA, A., POKORNÝ, D., VEIGL, D., JAHODA, D.: Postoperative sciatic nerve palsy after hip joint surgery. Acta Chir. orthop. Traum. čech., 65: 331-335, 1998.
- SOSNA, A., POKORNÝ, D., JAHODA, D.: Sciatic nerve palsy after total hip replacement. J. Bone Jt Surg., 87-B: 1140-1141, 2005.
Přejít k původnímu zdroji...
Přejít na PubMed...
- STEJSKAL, L., METELKA, M.: Injuries of the sciatic nerve. Rozhl. Chir., 53: 793-802, 1974.
- TOMAINO, M.M.: Complete sciatic nerve palsy after open femur fracture: Successful treatment with neurolysis 6 months after injury. Am. J. Orthop., 31: 585-588, 2002.
- YACOUBIAN, S.V., SAH, A.P., ESTOK, D.M. 2nd.: Incidence of sciatic nerve palsy after revision hip arthroplasty through a posterior approach. J. Arthroplasty, 25: 31-34, 2010.
Přejít k původnímu zdroji...
Přejít na PubMed...