Postoperative Lower Extremity Neuropathy With Boot Stirrups Compared With Candy Cane Stirrups

Area of Science:

• Surgical Safety
• Neurology
• Gynecology

Background:

• Lower extremity peripheral neuropathy is a potential complication following surgery.
• Stirrup type used during surgery may influence patient outcomes.

Purpose of the Study:

• To compare the risk of lower extremity peripheral neuropathy between candy cane stirrups and boot stirrups.
• To assess the association between stirrup type and postoperative neuropathy in women undergoing gynecologic surgery in the lithotomy position.

Main Methods:

• Retrospective cohort study of 2,449 patients undergoing gynecologic surgery.
• Comparison of neuropathy incidence between patients using boot stirrups versus candy cane stirrups.
• Logistic regression analysis adjusted for age, BMI, smoking, anesthesia type, and surgical time.

Main Results:

• Neuropathy occurred less frequently in the boot stirrup group (1.6%) compared to the candy cane stirrup group (3.4%).
• Candy cane stirrup use was independently associated with an increased risk of postoperative neuropathy (aOR 2.87).
• Longer surgical duration was also independently associated with increased neuropathy risk (aOR 1.40 per hour).

Conclusions:

• Candy cane stirrups are associated with a significantly higher risk of lower extremity postoperative neuropathy.
• Boot stirrups appear to be a safer option regarding postoperative neuropathy in this patient population.
• Surgical positioning and duration are critical factors in preventing postoperative neuropathy.