Advertisement for orthosearch.org.uk
Results 1 - 2 of 2
Results per page:
The Bone & Joint Journal
Vol. 97-B, Issue 10 | Pages 1345 - 1349
1 Oct 2015
Regev GJ Drexler M Sever R Dwyer T Khashan M Lidar Z Salame K Rochkind S

Sciatic nerve palsy following total hip arthroplasty (THA) is a relatively rare yet potentially devastating complication. The purpose of this case series was to report the results of patients with a sciatic nerve palsy who presented between 2000 and 2010, following primary and revision THA and were treated with neurolysis. A retrospective review was made of 12 patients (eight women and four men), with sciatic nerve palsy following THA. The mean age of the patients was 62.7 years (50 to 72; standard deviation 6.9). They underwent interfascicular neurolysis for sciatic nerve palsy, after failing a trial of non-operative treatment for a minimum of six months. Following surgery, a statistically and clinically significant improvement in motor function was seen in all patients. The mean peroneal nerve score function improved from 0.42 (0 to 3) to 3 (1 to 5) (p < 0.001). The mean tibial nerve motor function score improved from 1.75 (1 to 4) to 3.92 (3 to 5) (p = 0.02).The mean improvement in sensory function was a clinically negligible 1 out of 5 in all patients. In total, 11 patients reported improvement in their pain following surgery.

We conclude that neurolysis of the sciatic nerve has a favourable prognosis in patients with a sciatic nerve palsy following THA. Our findings suggest that surgery should not be delayed for > 12 months following injury.

Cite this article: Bone Joint J 2015;97-B:1345–9


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 307 - 307
1 Nov 2002
Lokiec F Rochkind S Yaniv M Wientroub S
Full Access

Despite the impressive advancements in prenatal planning and assessment, obstetrical brachial plexus palsy remains an unfortunate consequence of difficult childbirth.

Although the majority of infants with plexopathy recover with minor or no residual functional deficits, a number of children do not regain sufficient limb function and develop significant functional limitations, bony deformities and joint contractures.

Recent developments in the technique of microsurgical reconstruction of peripheral nerve injuries proved to be effective in selected cases of children with obstetrical brachial plexus injury.

Many of these children and those who were defined as having minor injury will remain with considerable functional limitation and deserve late orthopaedic reconstruction.

Based on that, we developed a multidisciplinary Brachial Plexus clinic gathering a microsurgeon, a pediatric orthopaedic surgeon, an electrophysiologist clinician, physiotherapists and occupational therapist in order to assess and evaluate these children.

A total of 105 children were seen and followed up in our clinic during the last 2 years.

Most of these children were referred to our clinic from other centers and from physiotherapists treating these children on an out-patient basis.

We report the orthopaedic reconstruction operations performed in 9 cases of residual functional disabilities in children born with obstetric palsy.

4 patients had latissimmus dorsi and teres major transfer.

2 patients had derotation osteotomy of the humerus.

1 patient had Steindler flexorplasty of the elbow.

2 patients had open reduction and capsulorrhapy for a dislocated shoulder.

Video assessment of these children was performed before and after the operation. Function was also analyzed before and after operation by a physiotherapist and an occupational therapist.

Significant functional improvement was achieved, to the satisfaction of patients and parents.