Your browser doesn't support javascript.
loading
Open Sciatic Nerve Decompression for Compartment Syndrome after Prolonged Lithotomy Position: A Case Report.
Lee, Se-Hwan; Hwang, Hong-Pil; Yoon, Sun-Jung.
Afiliación
  • Lee SH; Department of Orthopedic Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea.
  • Hwang HP; Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Korea.
  • Yoon SJ; Department of Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea.
Medicina (Kaunas) ; 58(10)2022 Oct 21.
Article en En | MEDLINE | ID: mdl-36295657
ABSTRACT

Background:

Position-related compressive nerve injury is a frequently reported complication of the lithotomy position. In contrast, compartment syndrome-induced neuropathy after lithotomy with prolonged surgery is rare and prone to misdiagnosis. This case describes the successful open decompression of sciatic neuropathy due to compartment syndrome after a prolonged lithotomy position. Case presentation A 56-year-old male patient complained of an abnormal sensation in the lower leg and difficulty in dorsiflexion and plantarflexion of the left foot and toes after laparoscopic anterior hepatic sectionectomy for 16 h in a lithotomy position. Physical examination revealed severe pain and paresthesia below the distal left thigh. In manual muscle test grading, dorsiflexion and plantarflexion of the left ankle and toes were classified as grade 1. Computed tomography and magnetic resonance imaging showed ischemic changes in the mid-thigh posterior muscles, and the sciatic nerve was severely swollen at the distal thigh, which was compressed by the proximal edge of the well-leg holder. After debridement of the necrotic tissue and decompression of the sciatic nerve, the pain subsided immediately, and the ankle and toe dorsiflexion motor function improved to grade 4.

Conclusions:

Most case reports of compressive neuropathy associated with the lithotomy position have been related to conservative treatment. However, if a lesion compressing the nerve is confirmed in an imaging study and the correlation with the patient's symptoms is evident, early surgical intervention can be an effective treatment method to minimize neurological deficits.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndromes Compartimentales / Neuropatía Ciática Tipo de estudio: Etiology_studies / Guideline Límite: Humans / Male / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndromes Compartimentales / Neuropatía Ciática Tipo de estudio: Etiology_studies / Guideline Límite: Humans / Male / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article
...