Entrapment of the Sciatic Nerve Over the Femoral Neck Stem After Closed Reduction of a Dislocated Total Hip Arthroplasty. (February 2019)

• Record Type: Journal Article
• Authors: Maeder, Benoît; Goetti, Patrick; Mahlouly, Jaad; Mustaki, Laurent; Buchegger, Thomas; Guyen, Olivier
• Is Part Of: Journal of the AAOS. Volume 3:Number 2(2019)
• Publication Date: 2019-02
• Subjects: Orthopedic surgery -- Periodicals; 617.4705
• DOI: 10.5435/JAAOSGlobal-D-18-00081
• Languages: English
• ISSNs: 2474-7661

Abstract

Abstract : Sciatic nerve injury is a rare but potentially extremely disabling complication of posterior dislocated total hip arthroplasty. Initial closed reduction is recommended followed by a careful neurovascular examination. This procedure and the following stability testing are usually safe and typically associated with a very low complication rate. We report the case of sciatic nerve entrapment around the neck of the femoral stem after closed reduction of a posteriorly dislocated total hip arthroplasty. Immediate postreduction palsy led to surgical exploration, identification, neurolysis of the sciatic nerve and safe reduction was performed. Patient outcome was marked by complete sensitive sciatic nerve recovery, but complete loss of motor sciatic nerve function. This case highlights the importance of careful postreduction neurovascular assessment and prompt surgical exploration when indicated.