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Isolated sciatic nerve entrapment by ectopic bone after femoral head fracture-dislocation
Oke A Anakwenze1, Vamsi Kancherla, Nancy M Major
1Department of Orthopaedic Surgery, University of Pennsylvania, PA 19104, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|June 28, 2013
Summary
Posttraumatic pelvic heterotopic ossification (HO) is common after hip dislocations, but nerve damage is rare. Surgical removal of HO and nerve decompression can successfully treat persistent symptoms.
Area of Science:
- Orthopedic Surgery
- Neurology
- Radiology
Background:
- Posttraumatic heterotopic ossification (HO) is a known complication following hip fracture dislocation.
- Nerve encasement by heterotopic ossification can occur, but significant neurologic deficit is uncommon.
Observation:
- Clinical suspicion and detailed patient history are crucial for diagnosis.
- Advanced imaging like CT and MRI aid in surgical planning.
- Conservative management may be attempted for persistent symptoms.
Findings:
- Neurologic deficits resulting from pelvic heterotopic ossification are rare despite potential nerve encasement.
- Surgical intervention, including HO excision and nerve neurolysis, is effective for recalcitrant cases.
Implications:
- Early recognition and appropriate workup are essential for managing potential neurologic complications.
- Surgical treatment offers a successful outcome for patients with persistent symptoms unresponsive to conservative measures.
- This highlights the importance of a multidisciplinary approach involving orthopedic surgeons and neurologists.
