The Standard Implantation of a Total Hip Prosthesis Via Two Incisions (the Yale Technique)

Kipping, Robert

doi:10.1007/s00064-009-1809-1

Cited by 4 publications

(1 citation statement)

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“…Bei Ablösung dieses Muskels kann es zu dessen Retraktion mit konsekutiver Nervenschädigung kommen. Falls möglich, sollte deshalb der M. piriformis beim posterioren Zugang femoral nicht abgelöst werden [26]. Beim hinteren Zugang besteht außerdem das Risiko für eine Schädigung des N. glutaeus inferior, da dieser im direkten Zugangsweg liegt.…”

Section: Posteriorer Und Posterolateraler Zugangunclassified

Nervenläsionen nach minimal-invasiver Hüftendoprothetik

et al. 2012

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Although there is no clear evidence, minimally invasive hip arthroplasty seems to be associated with slightly higher complication rates compared to standard procedures. Major nerve palsy is one of the least common but most distressing complications. The key for minimizing the incidence of nerve lesions is to analyze preoperative risk factors, accurate knowledge of the anatomy and minimally invasive techniques. Once clinical signs of nerve injury are evident, the first diagnostic steps are localization of the lesion and quantification of the damage pattern. Therefore, clinical assessment of the neurological deficits should be performed as soon as possible. Apart from rare cases of isolated transient conduction blockade or complete transection, the damage pattern is mostly combined. Thus, there can be evidence for dysfunction of nerve conduction (neuropraxia) and structural nerve damage (axonotmesis or neurotmesis) simultaneously. Because the earliest signs of denervation are detectable via electromyography after 1 week, it is not possible to make any reliable prognosis within the first days after nerve injury using electrophysiological methods. This review article should serve as a guideline for prevention, diagnostics and therapy of neural lesions in minimally invasive hip arthroplasty.

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Section: Posteriorer Und Posterolateraler Zugangunclassified