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Shujauddin M, Hantouly AT, Moghamis I, Alzobi O, Mazhar FV, Mekhaimar MM. Gluteal compartment syndrome secondary to prolonged immobilization following carbon monoxide poisoning associated with leukoencephalopathy: A case report. Heliyon 2024; 10:e26217. [PMID: 38439871 PMCID: PMC10909629 DOI: 10.1016/j.heliyon.2024.e26217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Gluteal compartment syndrome (GCS) is a rare diagnosis that results mostly from a non-traumatic etiology. We describe a case of a gluteal compartment syndrome, complicated with sciatic nerve palsy. Case presentation This paper reported a case of gluteal compartment syndrome caused by prolonged immobilization due to carbon monoxide poisoning. The case was complicated with sciatic nerve palsy and a sequala of leukoencephalopathy. Discussion and conclusion This case report highlighted the importance of having a high suspicion for gluteal compartment syndrome in patients with history of lying down with prolonged immobilization. The diagnosis can be made solely on clinical examination and a fasciotomy must be performed with no delay.
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Affiliation(s)
- Mohammad Shujauddin
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ashraf T. Hantouly
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Isam Moghamis
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Osama Alzobi
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fuad Vayalil Mazhar
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Maged Mekhaimar
- Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Murena L, Colin G, Dussi M, Canton G. Is intraoperative neuromonitoring effective in hip and pelvis orthopedic and trauma surgery? A systematic review. J Orthop Traumatol 2021; 22:40. [PMID: 34647237 PMCID: PMC8514601 DOI: 10.1186/s10195-021-00605-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Sciatic nerve injury is an uncommon but potentially devastating complication in hip and pelvis surgery. Intraoperative nerve monitoring (IONM) was applied since the seventies in neurosurgery and spine surgery. Nowadays, IONM has gained popularity in other surgical specialities including orthopaedic and trauma surgery. Aim of this systematic review is to resume the literature evidences about the effectiveness of intraoperative monitoring of sciatic nerve during pelvic and hip surgery. Methods Two reviewers (GC and MD) independently identified studies by a systematic search of PubMed and Google Scholar from inception of database to 10 January 2021. Inclusion criteria were: (a) English written papers, (b) use of any type of intraoperative nerve monitoring during traumatic or elective pelvic and hip surgery, (c) comparison of the outcomes between patients who underwent nerve monitoring and patient who underwent standard procedures, (d) all study types including case reports. The present review was conducted in accordance with the 2009 PRISMA statement. Results The literature search produced 224 papers from PubMed and 594 from Google Scholar, with a total amount of 818 papers. The two reviewer excluded 683 papers by title or duplicates. Of the 135 remaining, 72 were excluded after reading the abstract, and 31 by reading the full text. Thus, 32 papers were finally included in the review. Conclusions The use of IONM during hip and pelvis surgery is debated. The review results are insufficient to support the routine use of IONM in hip and pelvis surgery. The different IONM techniques have peculiar advantages and disadvantages and differences in sensitivity and specificity without clear evidence of superiority for any. Results from different studies and different interventions are often in contrast. However, there is general agreement in recognizing a role for IONM to define the critical maneuvers, positions or pathologies that could lead to sciatic nerve intraoperative damage. Level of evidence Level 2.
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Affiliation(s)
- Luigi Murena
- Orthopaedics and Traumatology Unit, Cattinara Hospital-ASUGI, Strada di Fiume 447, 34149, Trieste, Italy
| | - Giulia Colin
- Orthopaedics and Traumatology Unit, Cattinara Hospital-ASUGI, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Micol Dussi
- Orthopaedics and Traumatology Unit, Cattinara Hospital-ASUGI, Strada di Fiume 447, 34149, Trieste, Italy
| | - Gianluca Canton
- Orthopaedics and Traumatology Unit, Cattinara Hospital-ASUGI, Strada di Fiume 447, 34149, Trieste, Italy
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Naik P, Patel P, Shah N, Suthar R. Congenital Pseudarthrosis of Femur and Sciatic Nerve Palsy with Congenital Constriction Band Syndrome: Report of the First Case in Literature. Indian J Orthop 2021; 55:1050-1055. [PMID: 34194662 PMCID: PMC8192661 DOI: 10.1007/s43465-021-00383-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/10/2021] [Indexed: 02/04/2023]
Abstract
Congenital constriction band syndrome has varied clinical presentations ranging from small, incomplete skin deep constriction band to in utero amputation. Pseudarthrosis of underlying bone most commonly tibia has been reported by many authors. We report the first case of congenital pseudarthrosis of the femur with congenital constriction band syndrome. Nine-day-old female presented with the constriction band in the left thigh with open pseudarthrosis of the femur. The left femur had gross recurvatum deformity and the posterior apex of the pseudarthrosis was exposed via skin ulceration. She had an ipsilateral paralytic clubfoot. She was treated with single-stage excision of constriction band and Z-plasty. Spontaneous union of the femur was achieved at 3 months. Procurvatum deformity of the femur improved gradually over 3 years. This happens to be the first and only reported case of congenital pseudarthrosis of the femur with sciatic nerve palsy due to congenital constriction band.
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Affiliation(s)
- Premal Naik
- Rainbow Superspeciality Hospital and Children’s Orthopaedic Centre, Next To Asia School, Behind HDFC Bank, Opposite Drive In Cinema, Bodakdev, Ahmedabad, Gujarat 380 054 India
- Honorary Paediatric Orthopaedic Surgeon, Smt S C L Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat India
| | - Parimal Patel
- Government Medical College and New Civil Hospital, Surat, Gujarat India
| | - Nihar Shah
- Geetanjali Medical College and Hospital, Udaipur, Rajasthan India
| | - Raghav Suthar
- AMC MET College, L G Hospital, Ahmedabad, Gujarat India
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Sivakumaran D, Pathinathan K, Danisious J, Thayasivam G. Myositis ossificans of the hip joint causing sciatic nerve palsy following Guillain-barré syndrome: A case report. Int J Surg Case Rep 2021; 84:106110. [PMID: 34171613 PMCID: PMC8234345 DOI: 10.1016/j.ijscr.2021.106110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Myositis ossificans of the hip is a rare entity caused by trauma and neurological conditions which lead to lamellar bone formation around the joint. CASE PRESENTATION We present a 47 years old patient with myositis ossificans of the left and the piriformis muscle following Guillain Barré syndrome causing sciatic nerve palsy (Piriformis syndrome). CLINICAL DISCUSSION Clinical assessment revealed global limitation of the left hip movements and palpable bony mass on the lateral aspect of the left hip. Radiographs and computed tomography showed extensive myositis ossificans of the left hip and non-bridging calcification noted on the asymptomatic right side. During initial medical management and physiotherapy patient developed sciatic nerve palsy due to piriformis syndrome and ankylosis of the hip on the left side. Surgical exploration of the sciatic nerve and debridement of the hip. The left hip was found ankylosed and not salvageable. Uncemented total hip arthroplasty was carried out in the session. The patient recovered completely from sciatic nerve palsy and regained the range of motion of the hip. He is under follow-up for the recurrence of myositis ossificans. CONCLUSION Guillain-barré syndrome causing piriformis syndrome is a rare entity. Extensive myositis ossificans causing sciatic nerve palsy is even rarer. An awareness of this entity, early detection, and intervention of this condition may help to preserve the native hip.
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Affiliation(s)
- Dishanth Sivakumaran
- Postgraduate trainee in Orthopaedicsurgery, Postgraduate institute of Medicine, University of Colombo, Sri Lanka.
| | - Kalaventhan Pathinathan
- Postgraduate trainee in Orthopaedicsurgery, Postgraduate institute of Medicine, University of Colombo, Sri Lanka
| | - Joy Danisious
- Postgraduate trainee in Orthopaedicsurgery, Postgraduate institute of Medicine, University of Colombo, Sri Lanka
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Abstract
This article reports the case of a 42-year-old male patient, who sustained a gluteal compartment syndrome after drug-induced immobilization with subsequent rhabdomyolysis and sciatic nerve palsy. Unlike compartment syndrome of the forearm or lower leg, this is a rare condition. After immediate surgical decompression and installation of negative pressure wound treatment, hemofiltration in acute renal failure could be averted using forced diuresis. The sensorimotor function of the lower extremity improved already after the first treatment and secondary wound closure was possible after 1 week. The patient was discharged 11 days after admission with complete recovery of sensorimotor and renal functions.
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Affiliation(s)
- J Gleich
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Campus Innenstadt und Großhadern, Marchioninistraße 17, 81377, München, Deutschland.
| | - J Fürmetz
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Campus Innenstadt und Großhadern, Marchioninistraße 17, 81377, München, Deutschland
| | - C Kamla
- Herzchirurgische Klinik und Poliklinik, Klinikum der Universität München, München, Deutschland
| | - V Pedersen
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Campus Innenstadt und Großhadern, Marchioninistraße 17, 81377, München, Deutschland
| | - W Böcker
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Campus Innenstadt und Großhadern, Marchioninistraße 17, 81377, München, Deutschland
| | - A M Keppler
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Campus Innenstadt und Großhadern, Marchioninistraße 17, 81377, München, Deutschland
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Kanda A, Kaneko K, Obayashi O, Mogami A, Morohashi I. Treatment of postoperative sciatic nerve palsy after total hip arthroplasty for postoperative acetabular fracture: A case report. Ann Med Surg (Lond) 2016; 11:39-41. [PMID: 27672438 PMCID: PMC5030320 DOI: 10.1016/j.amsu.2016.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 08/28/2016] [Accepted: 08/29/2016] [Indexed: 11/29/2022] Open
Abstract
Acetabular fracture is usually treated with osteosynthesis. However, in the case of an intra-articular fracture, osteosynthesis can result in arthropathy of the hip joint and poor long-term results, hence, total hip arthroplasty is required. However, in total hip arthroplasty for postoperative acetabular fracture, sciatic nerve palsy tends to develop more commonly than after primary total hip arthroplasty. This is a case report of a 57-year-old Japanese male who had internal skeletal fixation for a left acetabular fracture that had occurred 2 years earlier. One year later, he developed coxarthrosis and severe pain of the hip joint and total hip arthroplasty was performed. After the second surgery, he experienced pain along the distribution of the sciatic nerve and weakness of the muscles innervated by the peroneal nerve, indicating sciatic nerve palsy. We performed a third operation, and divided adhesions around the sciatic nerve. Postoperatively, the anterior hip joint pain and the buttocks pain when the hip was flexed were improved. Abduction of the fifth toe was also improved. However, the footdrop and sensory disturbance were not improved. A year after the third operation, sensory disturbance was slightly improved but the footdrop was not improved. We believe the sciatic nerve palsy developed when we dislocated the hip joint as the sciatic nerve was excessively extended as the hip joint flexed and internally rotated. Sciatic nerve adhesion can occur easily in total hip replacement for postoperative acetabular fracture; hence, adhesiotomy should be conducted before performing hip dislocation to prevent injury caused by nerve tension. The patient agreed that the details of this case could be submitted for publication. The work has been reported in line with the CARE criteria and cite.
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Affiliation(s)
- Akio Kanda
- Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Nagaoka 1129, Izunokuni, 410-2295, Shizuoka, Japan
| | - Kazuo Kaneko
- Department of Orthopaedic Surgery, Juntendo University, Hongou 3-1-3, Bunkyou Ward, 113-8431, Tokyo, Japan
| | - Osamu Obayashi
- Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Nagaoka 1129, Izunokuni, 410-2295, Shizuoka, Japan
| | - Atsuhiko Mogami
- Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Nagaoka 1129, Izunokuni, 410-2295, Shizuoka, Japan
| | - Itaru Morohashi
- Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Nagaoka 1129, Izunokuni, 410-2295, Shizuoka, Japan
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Emamhadi M, Saberi A, Andalib S. Sciatic nerve injuries following femoral shaft fractures: Does the time interval from injury to surgery matter? Clin Neurol Neurosurg 2016; 147:6-10. [PMID: 27239897 DOI: 10.1016/j.clineuro.2016.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Sciatic nerve injuries following fractures of femoral shaft are uncommon complications. The patients with such deficits present with sciatic nerve palsy. A few cases of sciatic nerve injuries secondary to femoral shaft fractures have thus far been reported. If such patients fail to improve spontaneously, they may require surgical exploration. The present paper gives an account of surgical exploration in patients presenting with sciatic nerve injuries following femoral shaft fractures. PATIENTS AND METHODS Clinical outcomes were assessed in 14 patients undergoing surgical exploration of sciatic nerve injuries following femoral shaft fractures. RESULTS There was a significant negative correlation between the time interval from injury to surgery and motor function recovery. Furthermore, a negative but non-significant correlation was seen between the time interval from injury to surgery and sensory recovery. CONCLUSIONS Early exploration of sciatic nerve injuries following femoral shaft fractures can be beneficial if the nerve injury does not improve spontaneously.
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Park JS, Kim WJ, Hong CH, Soh JW, Nho JH, Suh YS, Lee HW. Sciatic Nerve Palsy Caused by Ruptured and Contracted Short External Rotator Muscles after Primary Total Hip Arthroplasty. Hip Pelvis 2015; 27:120-4. [PMID: 27536614 PMCID: PMC4972627 DOI: 10.5371/hp.2015.27.2.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 05/27/2015] [Accepted: 06/02/2015] [Indexed: 11/24/2022] Open
Abstract
Although the incidence of sciatic nerve palsy following total hip arthroplasty is low, this complication can cause devastating permanent nerve palsy. The authors experienced a case of sciatic nerve palsy caused by ruptured and contracted external rotator muscles following total hip arthroplasty in a patient suffering from osteonecrosis of the femoral head. We report this unusual case of sciatic nerve palsy with a review of the literature.
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Affiliation(s)
- Jong-Seok Park
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Woo-Jong Kim
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Chang-Hwa Hong
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jae-Wan Soh
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jae-Hwi Nho
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - You-Sung Suh
- Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hwan-Woong Lee
- Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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