Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach
Background Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural isc...
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| Veröffentlicht in: | Journal of orthopaedics and traumatology 2009-09, Vol.10 (3), p.123-126 |
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| creator | Kiyama, Takahiko Naito, Masatoshi Shiramizu, Kei Shinoda, Tuyoshi Maeyama, Akira |
| description | Background
Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural ischemia of LFCN and postoperative sensory disturbance.
Materials and methods
Nineteen patients who underwent periacetabular osteotomy through the Smith-Petersen approach were investigated. To evaluate neural ischemia, we measured the blood flow of LFCN using a laser Doppler flowmetry. The measurements were performed before and after osteotomy at the point 1 cm distal from the lower border of the inguinal ligament. LFCN was retracted to the medial side during the procedure. There was no direct trauma to LFCN in all cases. Postoperative sensory disturbance was evaluated at 2 weeks, 3 months, and 1 year follow-up after surgery.
Results
After osteotomy, the blood flow of LFCN was decreased to 2.4 from 3.3 ml min
−1
100 g
−1
when compared with that before osteotomy (
P
|
| doi_str_mv | 10.1007/s10195-009-0055-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2744732</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>734038105</sourcerecordid><originalsourceid>FETCH-LOGICAL-c531t-8597a51b78ebc08d5e7e776ecb39cc4831b0c6996e9371703ab227e7d4d3a05a3</originalsourceid><addsrcrecordid>eNqNkl9r3iAUxqVsrH8_QG-GMNiusnpijPFmUMrWFQottL0WY87bpCQxU1Pot58hL103aJkgCufno-fxIeQY2FdgTJ4EYKBExphKU4hM7JA9EIplKo13z_scdsl-CA-MgRSq_EB20ykBvGB7ZLgItsWhM9RtaGyR9iaiNz3d4OCW1c7RjOjmQEf0j0ib2XfjPZ3Qd8ZiNPXcG09diOiiG57oHJbyzdDFNrvGpBVwpGaavDO2PSTvN6YPeLRdD8jdj--3Zz-zy6vzi7PTy8wKDjGrhJJGQC0rrC2rGoESpSzR1lxZW1QcamZLpUpUXIJk3NR5npCmaLhhwvAD8m3VneZ6wMbiGFMvevLdYPyTdqbTf1fGrtX37lHnsigkz5PAl62Ad79mDFEPXbDY96sXWibzeAVMJPLzm2QOhShVcvs_QC5S4wn89A_44GY_Jr80lCVwKaSsEgUrZb0LwePmuTtgekmHXtOhUzr0kg69vPXjS1v-nNjGIQH5CoRp-WX0L65-VfU3s9DHBQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1661375778</pqid></control><display><type>article</type><title>Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Springer Nature OA Free Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kiyama, Takahiko ; Naito, Masatoshi ; Shiramizu, Kei ; Shinoda, Tuyoshi ; Maeyama, Akira</creator><creatorcontrib>Kiyama, Takahiko ; Naito, Masatoshi ; Shiramizu, Kei ; Shinoda, Tuyoshi ; Maeyama, Akira</creatorcontrib><description>Background
Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural ischemia of LFCN and postoperative sensory disturbance.
Materials and methods
Nineteen patients who underwent periacetabular osteotomy through the Smith-Petersen approach were investigated. To evaluate neural ischemia, we measured the blood flow of LFCN using a laser Doppler flowmetry. The measurements were performed before and after osteotomy at the point 1 cm distal from the lower border of the inguinal ligament. LFCN was retracted to the medial side during the procedure. There was no direct trauma to LFCN in all cases. Postoperative sensory disturbance was evaluated at 2 weeks, 3 months, and 1 year follow-up after surgery.
Results
After osteotomy, the blood flow of LFCN was decreased to 2.4 from 3.3 ml min
−1
100 g
−1
when compared with that before osteotomy (
P
< 0.01). Postoperatively, 14 of 19 patients had sensory disturbance at 2 weeks, 8 of 19 patients at 3 months, and 2 of 19 patients at 1 year follow-up. The blood flows of both patients who had persistent symptoms over 1 year after surgery had been decreased by more than 50% during operation.
Conclusions
Decrease of blood flow of LFCN by more than 50% seems to cause persistent symptoms after surgery through the Smith-Petersen approach even if direct trauma to the nerve is avoided. Excessive traction by retractors is thought to be the main cause of blood flow reduction.</description><identifier>ISSN: 1590-9921</identifier><identifier>EISSN: 1590-9999</identifier><identifier>DOI: 10.1007/s10195-009-0055-5</identifier><identifier>PMID: 19551340</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acetabulum - surgery ; Adolescent ; Adult ; Conservative Orthopedics ; Female ; Femoral Nerve - blood supply ; Femoral Nerve - injuries ; Humans ; Ischemia - etiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original ; Original Article ; Orthopedics ; Osteotomy - adverse effects ; Osteotomy - methods ; Paresthesia - etiology ; Regional Blood Flow ; Rheumatology ; Sports Medicine ; Surgical Orthopedics ; Traumatic Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of orthopaedics and traumatology, 2009-09, Vol.10 (3), p.123-126</ispartof><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-8597a51b78ebc08d5e7e776ecb39cc4831b0c6996e9371703ab227e7d4d3a05a3</citedby><cites>FETCH-LOGICAL-c531t-8597a51b78ebc08d5e7e776ecb39cc4831b0c6996e9371703ab227e7d4d3a05a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744732/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744732/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,41120,41488,42189,42557,51319,51576,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19551340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiyama, Takahiko</creatorcontrib><creatorcontrib>Naito, Masatoshi</creatorcontrib><creatorcontrib>Shiramizu, Kei</creatorcontrib><creatorcontrib>Shinoda, Tuyoshi</creatorcontrib><creatorcontrib>Maeyama, Akira</creatorcontrib><title>Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach</title><title>Journal of orthopaedics and traumatology</title><addtitle>J Orthopaed Traumatol</addtitle><addtitle>J Orthop Traumatol</addtitle><description>Background
Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural ischemia of LFCN and postoperative sensory disturbance.
Materials and methods
Nineteen patients who underwent periacetabular osteotomy through the Smith-Petersen approach were investigated. To evaluate neural ischemia, we measured the blood flow of LFCN using a laser Doppler flowmetry. The measurements were performed before and after osteotomy at the point 1 cm distal from the lower border of the inguinal ligament. LFCN was retracted to the medial side during the procedure. There was no direct trauma to LFCN in all cases. Postoperative sensory disturbance was evaluated at 2 weeks, 3 months, and 1 year follow-up after surgery.
Results
After osteotomy, the blood flow of LFCN was decreased to 2.4 from 3.3 ml min
−1
100 g
−1
when compared with that before osteotomy (
P
< 0.01). Postoperatively, 14 of 19 patients had sensory disturbance at 2 weeks, 8 of 19 patients at 3 months, and 2 of 19 patients at 1 year follow-up. The blood flows of both patients who had persistent symptoms over 1 year after surgery had been decreased by more than 50% during operation.
Conclusions
Decrease of blood flow of LFCN by more than 50% seems to cause persistent symptoms after surgery through the Smith-Petersen approach even if direct trauma to the nerve is avoided. Excessive traction by retractors is thought to be the main cause of blood flow reduction.</description><subject>Acetabulum - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Conservative Orthopedics</subject><subject>Female</subject><subject>Femoral Nerve - blood supply</subject><subject>Femoral Nerve - injuries</subject><subject>Humans</subject><subject>Ischemia - etiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteotomy - adverse effects</subject><subject>Osteotomy - methods</subject><subject>Paresthesia - etiology</subject><subject>Regional Blood Flow</subject><subject>Rheumatology</subject><subject>Sports Medicine</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1590-9921</issn><issn>1590-9999</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkl9r3iAUxqVsrH8_QG-GMNiusnpijPFmUMrWFQottL0WY87bpCQxU1Pot58hL103aJkgCufno-fxIeQY2FdgTJ4EYKBExphKU4hM7JA9EIplKo13z_scdsl-CA-MgRSq_EB20ykBvGB7ZLgItsWhM9RtaGyR9iaiNz3d4OCW1c7RjOjmQEf0j0ib2XfjPZ3Qd8ZiNPXcG09diOiiG57oHJbyzdDFNrvGpBVwpGaavDO2PSTvN6YPeLRdD8jdj--3Zz-zy6vzi7PTy8wKDjGrhJJGQC0rrC2rGoESpSzR1lxZW1QcamZLpUpUXIJk3NR5npCmaLhhwvAD8m3VneZ6wMbiGFMvevLdYPyTdqbTf1fGrtX37lHnsigkz5PAl62Ad79mDFEPXbDY96sXWibzeAVMJPLzm2QOhShVcvs_QC5S4wn89A_44GY_Jr80lCVwKaSsEgUrZb0LwePmuTtgekmHXtOhUzr0kg69vPXjS1v-nNjGIQH5CoRp-WX0L65-VfU3s9DHBQ</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Kiyama, Takahiko</creator><creator>Naito, Masatoshi</creator><creator>Shiramizu, Kei</creator><creator>Shinoda, Tuyoshi</creator><creator>Maeyama, Akira</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><general>Springer Milan</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7TK</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090901</creationdate><title>Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach</title><author>Kiyama, Takahiko ; Naito, Masatoshi ; Shiramizu, Kei ; Shinoda, Tuyoshi ; Maeyama, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-8597a51b78ebc08d5e7e776ecb39cc4831b0c6996e9371703ab227e7d4d3a05a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acetabulum - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Conservative Orthopedics</topic><topic>Female</topic><topic>Femoral Nerve - blood supply</topic><topic>Femoral Nerve - injuries</topic><topic>Humans</topic><topic>Ischemia - etiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteotomy - adverse effects</topic><topic>Osteotomy - methods</topic><topic>Paresthesia - etiology</topic><topic>Regional Blood Flow</topic><topic>Rheumatology</topic><topic>Sports Medicine</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiyama, Takahiko</creatorcontrib><creatorcontrib>Naito, Masatoshi</creatorcontrib><creatorcontrib>Shiramizu, Kei</creatorcontrib><creatorcontrib>Shinoda, Tuyoshi</creatorcontrib><creatorcontrib>Maeyama, Akira</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of orthopaedics and traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiyama, Takahiko</au><au>Naito, Masatoshi</au><au>Shiramizu, Kei</au><au>Shinoda, Tuyoshi</au><au>Maeyama, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach</atitle><jtitle>Journal of orthopaedics and traumatology</jtitle><stitle>J Orthopaed Traumatol</stitle><addtitle>J Orthop Traumatol</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>10</volume><issue>3</issue><spage>123</spage><epage>126</epage><pages>123-126</pages><issn>1590-9921</issn><eissn>1590-9999</eissn><abstract>Background
Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural ischemia of LFCN and postoperative sensory disturbance.
Materials and methods
Nineteen patients who underwent periacetabular osteotomy through the Smith-Petersen approach were investigated. To evaluate neural ischemia, we measured the blood flow of LFCN using a laser Doppler flowmetry. The measurements were performed before and after osteotomy at the point 1 cm distal from the lower border of the inguinal ligament. LFCN was retracted to the medial side during the procedure. There was no direct trauma to LFCN in all cases. Postoperative sensory disturbance was evaluated at 2 weeks, 3 months, and 1 year follow-up after surgery.
Results
After osteotomy, the blood flow of LFCN was decreased to 2.4 from 3.3 ml min
−1
100 g
−1
when compared with that before osteotomy (
P
< 0.01). Postoperatively, 14 of 19 patients had sensory disturbance at 2 weeks, 8 of 19 patients at 3 months, and 2 of 19 patients at 1 year follow-up. The blood flows of both patients who had persistent symptoms over 1 year after surgery had been decreased by more than 50% during operation.
Conclusions
Decrease of blood flow of LFCN by more than 50% seems to cause persistent symptoms after surgery through the Smith-Petersen approach even if direct trauma to the nerve is avoided. Excessive traction by retractors is thought to be the main cause of blood flow reduction.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>19551340</pmid><doi>10.1007/s10195-009-0055-5</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Acetabulum - surgery Adolescent Adult Conservative Orthopedics Female Femoral Nerve - blood supply Femoral Nerve - injuries Humans Ischemia - etiology Male Medicine Medicine & Public Health Middle Aged Original Original Article Orthopedics Osteotomy - adverse effects Osteotomy - methods Paresthesia - etiology Regional Blood Flow Rheumatology Sports Medicine Surgical Orthopedics Traumatic Surgery Treatment Outcome Young Adult |
| title | Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach |
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