人工全髋关节置换术后神经损伤
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摘要
神经损伤是人工全髋关节置换术后并发症之一,可引起严重的损害,甚至会导致患者终身的残疾。神经损伤后恢复缓慢,部分患者神经系统功能可能终生都无法恢复正常,这将严重影响人工全髋关节置换术后患者的预后及生活质量。因此,全髋关节置换术后的神经损伤常常引起法律诉讼。骨关节科医生必须予以高度重视。本文对髋关节置换术后神经损伤的原因及造成神经损伤的高风险因素进行分析,为减少人工全髋关节置换术后神经损伤的发生提供指导。
Nerve injury is one of the complications following total hip arthroplasty( THA),it may cause serious damage to the patient. Even,some patients may be left with severe disability. Recovery from a nerve injury can be very slow,and a part of nerve injuries,whether complete or incomplete,never fully resolved. This may cause difficulty with the post-operative rehabilitation,and the life of the patient. As so,nerve injury is a frequent cause of malpractice lawsuits after THA. Surgeons should pay more attentions to this devastating complication. The potential etiologies and the risk factors of nerve lesion were analyzed in this review,for the purpose of providing guidance for the reduction of nerve injury after total hip replacement.
Nerve injury is one of the complications following total hip arthroplasty( THA),it may cause serious damage to the patient. Even,some patients may be left with severe disability. Recovery from a nerve injury can be very slow,and a part of nerve injuries,whether complete or incomplete,never fully resolved. This may cause difficulty with the post-operative rehabilitation,and the life of the patient. As so,nerve injury is a frequent cause of malpractice lawsuits after THA. Surgeons should pay more attentions to this devastating complication. The potential etiologies and the risk factors of nerve lesion were analyzed in this review,for the purpose of providing guidance for the reduction of nerve injury after total hip replacement.
引文
[1] Oldenburg M, Muller R T. The frequency, prognosis and significance of nerve injuries in total hip arthroplasty[J]. Int Orthop,1997,21(1):1-3.
[2] Yang IH. Neurovascular injury associated with hip arthroplasty[J]. Hip Pelvis,2014,26(2):74-78
[3] Schmalzried TP,Noordin S,Amstutz HC. Update on nerve palsy associated with total hip replacement[J]. Clin Orthop Relat Res,1997,(344):188-206.
[4] Farrell CM,Springer BD,Haidukewych GJ,et al. Motor nerve palsy following primary total hip arthroplasty[J]. J Bone Joint Surg Am,2005,87(12):2619-2625.
[5] Dietze S,Perka C,Baecker H. Blood vessel and nerve damage in total hip arthroplasty[J]. Orthopade,2014,43(1):64-69.
[6] Johanson NA,Pellicci PM,Tsairis P,et al. Nerve injury in total hip arthroplasty[J]. Clin Orthop Relat Res,1983,(179):214-222.
[7] Upadhyay A,York S,Macaulay W,et al. Medical malpractice in hip and knee arthroplasty[J]. J Arthroplasty,2007,22(6,2):2-7.
[8]王辉.坐骨神经损伤的临床应用解剖分析[J].中国实用神经疾病杂志,2015,18(24):101-102.
[9] Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence:a review[J]. Clin Anat,2010,23(1):8-17.
[10] Gogus A,Ozturk C,Sirvanci M,et al. Femoral nerve palsy due to iliacus hematoma occurred after primary total hip arthroplasty[J].Arch Orthop Trauma Surg,2008,128(7):657-660.
[11] Ng J, Marson BA, Broodryk A. Foot drop following closed reduction of a total hip replacement[J/OL]. BMJ case reports,2016, 22:pii:bcr2016215010. doi:10. 1136/bcr-2016-215010.
[12]徐朝阳,任彦红,涂丽莉,等.股神经周围筋膜及其毗邻结构的解剖[J].解剖学报,2013,44(3):364-367.
[13] Brown GD,Swanson EA,Nercessian OA. Neurologic injuries after total hip arthroplasty[J]. Am J Orthop(Belle Mead NJ),2008,37(4):191-197.
[14] Fox AJ,Bedi A,Wanivenhaus F,et al. Femoral neuropathy following total hip arthroplasty Review and management guidelines[J]. Acta Orthop Belg,2012,78(2):145-151.
[15] Liman J,von Gottberg P,Bahr M,et al. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement:a case report[J/OL]. J Med Case Rep,2011,18(5):190. doi:10.1186/1752-1947-5-190.
[16]刘建寅,郭强,李庆泰,等. 26例股神经损伤的临床治疗分析[J].中华显微外科杂志,2006,29(2):95-96.
[17] Wasielewski RC,Crossett LS,Rubash HE. Neural and vascular injury in total hip arthroplasty[J]. Orthop Clin North Am,1992,23(2):219-235.
[18] Fricker R M,Troeger H,Pfeiffer K M. Obturator nerve palsy due to fixation of an acetabular reinforcement ring with transacetabular screws. A case report[J]. J Bone Joint Surg Am,1997,79(3):444-446.
[19] Ramesh M,O’Byrne JM,Mc Carthy N,et al. Damage to the superior gluteal nerve after the Hardinge approach to the hip[J]. J Bone Joint Surg Br,1996,78(6):903-906.
[20] Dehart MM,Riley LJ. Nerve injuries in total hip arthroplasty[J].J Am Acad Orthop Surg,1999,7(2):101-111.
[21] Park JH,Hozack B,Kim P,et al. Common peroneal nerve palsy following total hip arthroplasty:prognostic factors for recovery[J/OL]. J Bone Joint Surg Am,2013,95A(9):e55. doi:10.2106/JBJS. L. 00160.
[22] Wilson JN,Scales JT. The Stanmore metal on metal total hip prosthesis using a three pin type cup. A follow-up of 100arthroplasties over nine years[J]. Clin Orthop Relat Res,1973,9(95):239-249.
[23] Darmanis S,Pavlakis D,Papanikolaou A,et al. Neurovascular injury during primary total hip arthroplasty caused by a threaded acetabulum cup[J]. J Arthroplasty,2004,19(4):520-524.
[24] Simmons CJ,Izant TH,Rothman RH,et al. Femoral neuropathy following total hip arthroplasty. Anatomic study,case reports,and literature review[J]. J Arthroplasty,1991,6 Suppl:S57-S66.
[25] Weber ER,Daube JR,Coventry MB. Peripheral neuropathies associated with total hip arthroplasty[J]. J Bone Joint Surg Am,1976,58(1):66-69.
[26] Solheim LF,Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty[J]. Acta Orthop Scand,1980,51(3):531-534.
[27] Navarro RA, Schmalzried TP, Amstutz HC, et al. Surgical approach and nerve palsy in total hip arthroplasty[J]. J Arthroplasty,1995,10(1):1-5.
[28]邓磊,刘沂.全髋关节置换术的并发症及其处理(七)全髋关节置换后的神经并发症[J].中国骨肿瘤骨病,2005,4(1):40-44.
[29] Edwards BN,Tullos HS,Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty[J]. Clin Orthop Relat Res,1987,(218):136-141.
[30] Weale AE,Newman P,Ferguson IT,et al. Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study[J]. J Bone Joint Surg Br,1996,78(6):899-902.
[31]赵力,王振虎,赵岩,等.骨牵引在成人DDH全髋关节置换术中预防坐骨神经麻痹的应用[J].中国医药导刊,2017,19(1):7-8.
[32] Rasmussen TJ, Black DL, Bruce RP, et al. Efficacy of corticosomatosensory evoked potential monitoring in predicting and/or preventing sciatic nerve palsy during total hip arthroplasty[J]. J Arthroplasty,1994,9(1):53-61.
[33] Kennedy WF, Byrne TF, Majid HA, et al. Sciatic nerve monitoring during revision total hip arthroplasty[J]. Clinical orthopaedics and related research[J]. Clin Orthop Relat Res,1991,(264):223-227.
[34]陈艺,叶劲,白波,等.复杂髋关节手术中应用电生理监测技术预防下肢周围神经损伤[J/CD].中华关节外科杂志(电子版),2013,7(5):622-626.
[35]陈涛,杨春喜.人工全髋关节置换术治疗CroweⅣ型先天性髋关节发育不良截骨术的研究进展[J].中国修复重建外科杂志,2015,29(4):444-447.
[36]吴健,王兵,吴玉玲,等.粗隆下截骨结合Zweymuller假体全髋关节置换术治疗CroweⅣ型髋关节发育不良[J/CD].中华关节外科杂志(电子版),2014,08(5):608-612.
[37]沈晓峰,姜宏.全髋关节置换术后神经损伤的原因及预防措施[J].中医正骨,2013,25(1):46-48.
[38] Su EP. Post-operative neuropathy after total hip arthroplasty[J].Bone Joint J,2017,99-B(1 Suppl):46-49.
[39] Wooten SL,Mclaughlin RE. Iliacus hematoma and subsequent femoral nerve palsy after penetration of the medical acetabular wall during total hip arthroplasty. Report of a case[J]. Clin Orthop Relat Res,1984,(191):221-223.
[40] Zappe B,Glauser PM,Majewski M,et al. Long-term prognosis of nerve palsy after total hip arthroplasty:results of two-year-followups and long-term results after a mean time of 8 years[J]. Arch Orthop Trauma Surg,2014,134(10):1477-1482.
[41] Schmalzried TP,Amstutz HC,Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis[J]. J Bone Joint Surg Am,1991,73(7):1074-1080.
[2] Yang IH. Neurovascular injury associated with hip arthroplasty[J]. Hip Pelvis,2014,26(2):74-78
[3] Schmalzried TP,Noordin S,Amstutz HC. Update on nerve palsy associated with total hip replacement[J]. Clin Orthop Relat Res,1997,(344):188-206.
[4] Farrell CM,Springer BD,Haidukewych GJ,et al. Motor nerve palsy following primary total hip arthroplasty[J]. J Bone Joint Surg Am,2005,87(12):2619-2625.
[5] Dietze S,Perka C,Baecker H. Blood vessel and nerve damage in total hip arthroplasty[J]. Orthopade,2014,43(1):64-69.
[6] Johanson NA,Pellicci PM,Tsairis P,et al. Nerve injury in total hip arthroplasty[J]. Clin Orthop Relat Res,1983,(179):214-222.
[7] Upadhyay A,York S,Macaulay W,et al. Medical malpractice in hip and knee arthroplasty[J]. J Arthroplasty,2007,22(6,2):2-7.
[8]王辉.坐骨神经损伤的临床应用解剖分析[J].中国实用神经疾病杂志,2015,18(24):101-102.
[9] Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence:a review[J]. Clin Anat,2010,23(1):8-17.
[10] Gogus A,Ozturk C,Sirvanci M,et al. Femoral nerve palsy due to iliacus hematoma occurred after primary total hip arthroplasty[J].Arch Orthop Trauma Surg,2008,128(7):657-660.
[11] Ng J, Marson BA, Broodryk A. Foot drop following closed reduction of a total hip replacement[J/OL]. BMJ case reports,2016, 22:pii:bcr2016215010. doi:10. 1136/bcr-2016-215010.
[12]徐朝阳,任彦红,涂丽莉,等.股神经周围筋膜及其毗邻结构的解剖[J].解剖学报,2013,44(3):364-367.
[13] Brown GD,Swanson EA,Nercessian OA. Neurologic injuries after total hip arthroplasty[J]. Am J Orthop(Belle Mead NJ),2008,37(4):191-197.
[14] Fox AJ,Bedi A,Wanivenhaus F,et al. Femoral neuropathy following total hip arthroplasty Review and management guidelines[J]. Acta Orthop Belg,2012,78(2):145-151.
[15] Liman J,von Gottberg P,Bahr M,et al. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement:a case report[J/OL]. J Med Case Rep,2011,18(5):190. doi:10.1186/1752-1947-5-190.
[16]刘建寅,郭强,李庆泰,等. 26例股神经损伤的临床治疗分析[J].中华显微外科杂志,2006,29(2):95-96.
[17] Wasielewski RC,Crossett LS,Rubash HE. Neural and vascular injury in total hip arthroplasty[J]. Orthop Clin North Am,1992,23(2):219-235.
[18] Fricker R M,Troeger H,Pfeiffer K M. Obturator nerve palsy due to fixation of an acetabular reinforcement ring with transacetabular screws. A case report[J]. J Bone Joint Surg Am,1997,79(3):444-446.
[19] Ramesh M,O’Byrne JM,Mc Carthy N,et al. Damage to the superior gluteal nerve after the Hardinge approach to the hip[J]. J Bone Joint Surg Br,1996,78(6):903-906.
[20] Dehart MM,Riley LJ. Nerve injuries in total hip arthroplasty[J].J Am Acad Orthop Surg,1999,7(2):101-111.
[21] Park JH,Hozack B,Kim P,et al. Common peroneal nerve palsy following total hip arthroplasty:prognostic factors for recovery[J/OL]. J Bone Joint Surg Am,2013,95A(9):e55. doi:10.2106/JBJS. L. 00160.
[22] Wilson JN,Scales JT. The Stanmore metal on metal total hip prosthesis using a three pin type cup. A follow-up of 100arthroplasties over nine years[J]. Clin Orthop Relat Res,1973,9(95):239-249.
[23] Darmanis S,Pavlakis D,Papanikolaou A,et al. Neurovascular injury during primary total hip arthroplasty caused by a threaded acetabulum cup[J]. J Arthroplasty,2004,19(4):520-524.
[24] Simmons CJ,Izant TH,Rothman RH,et al. Femoral neuropathy following total hip arthroplasty. Anatomic study,case reports,and literature review[J]. J Arthroplasty,1991,6 Suppl:S57-S66.
[25] Weber ER,Daube JR,Coventry MB. Peripheral neuropathies associated with total hip arthroplasty[J]. J Bone Joint Surg Am,1976,58(1):66-69.
[26] Solheim LF,Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty[J]. Acta Orthop Scand,1980,51(3):531-534.
[27] Navarro RA, Schmalzried TP, Amstutz HC, et al. Surgical approach and nerve palsy in total hip arthroplasty[J]. J Arthroplasty,1995,10(1):1-5.
[28]邓磊,刘沂.全髋关节置换术的并发症及其处理(七)全髋关节置换后的神经并发症[J].中国骨肿瘤骨病,2005,4(1):40-44.
[29] Edwards BN,Tullos HS,Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty[J]. Clin Orthop Relat Res,1987,(218):136-141.
[30] Weale AE,Newman P,Ferguson IT,et al. Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study[J]. J Bone Joint Surg Br,1996,78(6):899-902.
[31]赵力,王振虎,赵岩,等.骨牵引在成人DDH全髋关节置换术中预防坐骨神经麻痹的应用[J].中国医药导刊,2017,19(1):7-8.
[32] Rasmussen TJ, Black DL, Bruce RP, et al. Efficacy of corticosomatosensory evoked potential monitoring in predicting and/or preventing sciatic nerve palsy during total hip arthroplasty[J]. J Arthroplasty,1994,9(1):53-61.
[33] Kennedy WF, Byrne TF, Majid HA, et al. Sciatic nerve monitoring during revision total hip arthroplasty[J]. Clinical orthopaedics and related research[J]. Clin Orthop Relat Res,1991,(264):223-227.
[34]陈艺,叶劲,白波,等.复杂髋关节手术中应用电生理监测技术预防下肢周围神经损伤[J/CD].中华关节外科杂志(电子版),2013,7(5):622-626.
[35]陈涛,杨春喜.人工全髋关节置换术治疗CroweⅣ型先天性髋关节发育不良截骨术的研究进展[J].中国修复重建外科杂志,2015,29(4):444-447.
[36]吴健,王兵,吴玉玲,等.粗隆下截骨结合Zweymuller假体全髋关节置换术治疗CroweⅣ型髋关节发育不良[J/CD].中华关节外科杂志(电子版),2014,08(5):608-612.
[37]沈晓峰,姜宏.全髋关节置换术后神经损伤的原因及预防措施[J].中医正骨,2013,25(1):46-48.
[38] Su EP. Post-operative neuropathy after total hip arthroplasty[J].Bone Joint J,2017,99-B(1 Suppl):46-49.
[39] Wooten SL,Mclaughlin RE. Iliacus hematoma and subsequent femoral nerve palsy after penetration of the medical acetabular wall during total hip arthroplasty. Report of a case[J]. Clin Orthop Relat Res,1984,(191):221-223.
[40] Zappe B,Glauser PM,Majewski M,et al. Long-term prognosis of nerve palsy after total hip arthroplasty:results of two-year-followups and long-term results after a mean time of 8 years[J]. Arch Orthop Trauma Surg,2014,134(10):1477-1482.
[41] Schmalzried TP,Amstutz HC,Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis[J]. J Bone Joint Surg Am,1991,73(7):1074-1080.