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Sciatic Nerve Palsy following Curved Periacetabular Osteotomy.
Masahiro Fujita1, Shinya Hayashi1, Kenichi Kikuchi1
1Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo 650-0017, Japan.
Case Reports in Orthopedics
|April 8, 2020
Summary
Postoperative sciatic nerve palsy following curved periacetabular osteotomy (CPO) can occur due to scar tissue strangulation, not direct injury. Early diagnosis and revision surgery can resolve symptoms like pain and numbness.
Area of Science:
- Orthopedic Surgery
- Neuroscience
- Reconstructive Surgery
Background:
- Curved periacetabular osteotomy (CPO) is a surgical procedure for hip dysplasia.
- CPO generally has satisfying outcomes with a low complication rate.
- Sciatic nerve palsy is a rare complication not previously reported after CPO.
Observation:
- A patient developed buttock pain and leg numbness after CPO.
- Postoperative MRI revealed sciatic nerve strangulation by scar tissue.
- No direct nerve injury, bone fragments, infection, or other pathologies were identified.
Findings:
- The patient's symptoms were diagnosed as sciatic nerve palsy caused by soft tissue strangulation.
- Revision surgery confirmed sciatic nerve entrapment by scar tissue.
- Surgical release of the scar tissue resolved the patient's pain and numbness.
Implications:
- Sciatic nerve palsy following CPO can result from scar tissue entrapment, independent of direct surgical trauma.
- Early detection and surgical intervention are crucial for favorable outcomes in such cases.
- This highlights the importance of considering soft tissue complications in postoperative nerve dysfunction after CPO.
