Nerve Injury in Traumatic Dislocation of the Hip

Cornwall, Roger; Radomisli, Timothy E.

doi:10.1097/00003086-200008000-00012

Cited by 157 publications

(61 citation statements)

References 35 publications

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“…Risk is increased in the presence of a femoral fracture [7] . The rate of sciatic nerve damage in the athletic TDHs in our review (3.6%) is lower than that demonstrated in TDHs of all aetiologies (>5%) [8,23,26,29,30] . A 2003 study of TDH (17% of which were sports associated, namely skiing or snowboarding) suggested that increased time to relocation or transfer to a second facility prior to reduction is associated with a higher risk of sciatic nerve damage.…”

contrasting

confidence: 70%

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

Connelly

O’Grady²

2015

International Journal of Orthopaedics

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AIM: High velocity athletic injuries account for approximately 5% of adult traumatic hip dislocations (TDHs). The aims of this literature review and case study are to highlight the presentation, pathophysiology and treatment of TDH in athletes and to propose a management algorithm. MATERIALS AND METHODS: A Pubmed search using keywords 'Traumatic hip dislocation,' 'hip injury in athletes' and 'sporting injury' was performed. Each manuscript was individually reviewed. For all cases of TDH secondary to athletic injury, patient presentation, treatment and outcome were recorded. A case of athletics associated TDH from our institution is described. RESULTS: 55 cases of athletics associated TDH were identified in the literature (82% male, 84% posterior). 54.5 % were sustained in snowboarding, 16.4% in skiing, 14.5% in football, 7.3% in rugby and 1.8% in basketball, skating, gymnastics and tennis. A concomitant femoral or acetabular fracture was demonstrated in 16 and 9 patients respectively. Two sustained a sciatic nerve injury. Conservative closed hip reduction was successful in 100% of cases attempted. We present a case of a 31 year old female who sustained a TDH playing Gaelic football treated with closed reduction. CONCLUSION: TDH from sporting injury is a relatively rare, commonly isolated injury that is amenable to closed reduction in the majority of cases. We report the first documented case of traumatic hip dislocation in Gaelic football and propose a management algorithm.

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contrasting

confidence: 70%

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

Connelly

O’Grady²

2015

International Journal of Orthopaedics

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“…Traumatic SN was identified in 13 children and was associated with femoral fractures (4) and pelvis trauma including hip dislocation (3) and trauma and tibial fractures (2). Traumatic fractures and dislocations of the hip may be complicated by SN in up to 5% of children; mechanisms of nerve injury include laceration, stretching, and late entrapment in heterotopic calcification.…”

Section: Resultsmentioning

confidence: 99%

“…Etiology. The etiology of sciatic nerve injury was varied (table) and included trauma (n ϭ 13), iatrogenic causes (n ϭ 13) including 8 orthopedic surgeries and 5 miscellaneous surgeries, prolonged extrinsic compression and immobilization (6), tumors (7), vascular (5), idiopathic and progressive (4), infantile and nonprogressive (2), and unknown, possible postviral (3).…”

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confidence: 99%

Pediatric sciatic neuropathies

Srinivasan¹,

Ryan

Escolar³

et al. 2011

Neurology

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Objective: The incidence, cause, and prognosis of sciatic neuropathy in children is not well understood. We report our 30-year experience of 53 patients with pediatric sciatic neuropathies (SN).Methods: Prospective review of the history, physical examination, electrophysiologic findings, and clinical course of children with SN. Results:The etiology of SN injury was varied and included trauma (13), iatrogenic causes (13) (8 orthopedic surgeries and 5 miscellaneous surgeries), prolonged extrinsic compression and immobilization (6), tumors (7), vascular (5), idiopathic and progressive (4), infantile and nonprogressive (2), and unknown, presumed postviral (3). Electrophysiologic studies demonstrated abnormalities in motor conduction studies of the peroneal nerve in 44/53 (83%) or tibial nerve in 35/51 (67%). Sensory conduction studies were abnormal in sural nerve in 34 of 43 cases (79%), and superficial peroneal nerves in 15/25 (60%). Needle EMG was abnormal in peroneal innervated muscles in all subjects, in tibial nerve innervated muscles in 43/51 (84%), and in the hamstrings in 18/29 (62%). Prognosis for recovery was variable and depended on the etiology and the severity of the nerve injury. Mononeuropathies are uncommon in children; however, in our experience, pediatric sciatic neuropathy (SN) represents approximately one-fourth of all mononeuropathies. Conclusions:1 SN lesions may be underappreciated in childhood. We describe the clinical features of children who presented with SN over a 30-year period. Clinical assessment. Staff neurologists, neurosurgeons, or orthopedic surgeons evaluated all children in the study before EMG evaluation. A staff electromyographer reviewed the history and neurologic examination at the time of the EMG with the patient and parents/ guardians. Follow-up data were obtained by clinical examination, review of charts, telephone conversations, and occasionally a repeat EMG. Electrophysiologic evaluation.Nerve conduction studies (NCS) and needle EMG were performed in children using Dantec Counterpoint (Dantec Electronic, Tonsbakken, Skovlunde, Denmark), TECS TE42 machine (Teca Corporation, Pleasantville, NY) or the Teca TM Synergy N-EM-EMG monitoring systems (Oxford Instruments, Oxford, UK); standard filter settings were utilized. Electrophysiologic studies were performed without sedation in the majority; in rare instances, sedation was used. In each child with a suspected SN, motor NCS included responses from the extensor digitorum brevis, abductor hallucis brevis, and in some instances tibialis anterior. Sensory NCS included sural nerve and in some instances superficial peroneal nerve responses. Plantar sensory responses were studied in preference to the technically difficult sural response in infants. Contralateral limbs were studied if there was possibility of a systemic process or multiple limb involvement. Normative data were as previously published. 1 H-reflex studies and F-wave studies were performed infrequently. Muscles

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“…23 Medikal tedavide ilk seçenek olarak kortikosteroidler değerlendirilir. Kortikosteroidler; doku şişmesini ve enflamasyonu azaltarak sinir dokusu üze-rindeki basıyı ortadan kaldırırlar, ayrıca kortikosteroid kullanımının sekonder yaralanmayı azaltabileceği ve membran stabilize edici etkisi ile normal homeostazı sağlayabileceği düşünülmektedir.…”

Section: Sġnġr Tamġrġ Medikal Tedaviunclassified

“…24 Analjezik ilaç kullanımı sinir yaralanmalarına bağlı ağrıların kontrol edilmesinde hastalara yardımcı olur. 23 Antiviral ajanlar, sinir yaralanmasının etyolojisinde bir faktör olan endonöral ödemi azaltmaya yardım ederler. 25 Hiperbarik oksijen (HBO) ise, akut travmatik yaralanmalarda yardımcı tedavidir, endo-nöral ödem ve kapiller damarlardaki basınç riskini azalttığı bildirilmiştir.…”

Section: Sġnġr Tamġrġ Medikal Tedaviunclassified

Di̇ş Heki̇mli̇ği̇nde Peri̇feri̇k Si̇ni̇r Yaralanmalari Ve Tedavi̇si̇

Er¹,

Duygu²,

Çanakçi³

et al. 2015

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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ÖZDiş hekimliğinde periferik sinir yaralanmaları, rutin işlemler sırasında, cerrahi uygulamalarda veya travma sonucunda sıklıkla karşılaşılan olgulardır. Sinirin yapısı ve sinir hasarı mekanizmaları konusunda bilgi sahibi olmak, doğru teşhis ve tedavi için oldukça önemlidir. Sinir yaralanmalarının tedavisi, temel olarak medikal tedavi ve cerrahi tedavi olarak ikiye ayrılır. Medikal tedavinin sonuç vermediği hastalarda, muhtemel cerrahi tedavi için seçenek ve sonuçlarını bilmek, bu kritik komplikasyonda, doğru zamanlama ve uygulama açısından büyük önem arz etmektedir. Bu derlemenin amacı; diş hekimliği klinik uygulamalarında karşılaşıla-bilecek periferik sinir yaralanmaları sebeplerini hatırlamak ve mevcut kitap bilgileri ile güncel literatür bilgilerini harmanlayarak bu önemli komplikasyon hakkında bilgi sahibi olmaktır. Anahtar kelimeler: diş hekimliği; medikal tedavi; periferik sinir yaralanması; sinir cerrahisi GĠRĠġSinir sistemi iç ve dış ortamda oluşan değişik-liklere ani yanıtın oluşturulduğu sistemdir. İç ortamda oluşan değişiklikleri düz kas, kalp kası ve salgı bezlerine gönderdiği emirlerle düzenleyip kontrol ederken; dış ortamda oluşan değişikliklere iskelet kaslarına emir göndererek yanıt verir. 1 İnsan vücudunda, sinir sistemi; merkezi sinir sistemi (MSS) ve periferik (çevresel) sinir sistemi (PSS) olarak iki kısımda incelenir.PSS'yi oluşturan sinirler horizontal kesitte içten dışa doğru incelendiğinde en dışta arter, ven ve lenfa- ABSTRACTPeripheral nerve injuries are frequently seen during routine procedures, surgical operations or after traumas in dentistry. Knowledge about the structure of the nerve tissue and nerve damage mechanisms is important for accurate diagnosis and treatment. Management of nerve injury is basically divided in two as medical and surgical treatment. It has a great importance to be aware of surgical treatment options and their possible results for correct timing and treatment in patients who do not respond to medical therapy. The purpose of this review is to to have information about peripheral nerve injuries and recent treatment approaches in clinical dental practice combining the book information and current literature. Key words: dentistry; peripheral nerve injury; medical treatment; surgical treatment tiklerin bulunduğu gevşek yapısı ile siniri dış etkenlere karşı koruyan epinöriyum tabakası görülür. Hemen altındaki perinöriyum, fasikül adı verilen akson demetlerini saran kuvvetli bir bağ dokusu olup, travma ve iskemiye karşı çok dayanıklıdır ve bu bariyerin bozulması halinde sinir iletimi önemli ölçüde etkilenir. Endonöriyum ise sinir liflerini çevreleyen gevşek bağ dokusu olup, içerisinde aksonlar, Schwann hücreleri, kollajen lifler, fibroblastlar, kapiller damarlar ve az sayıda mast hücresi ile makrofajlar vardır. Fasikül ise periferik sinirin en küçük anatomik birimi olup, cerrahi olarak diseke edilebilir ve görülebilir. 2

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Nerve Injury in Traumatic Dislocation of the Hip

Cited by 157 publications

References 35 publications

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

Traumatic Dislocations of the Hip in Athletes: A Case Report and Review of the Literature

Pediatric sciatic neuropathies

Di̇ş Heki̇mli̇ği̇nde Peri̇feri̇k Si̇ni̇r Yaralanmalari Ve Tedavi̇si̇

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