Open Sciatic Nerve Decompression for Compartment Syndrome after Prolonged Lithotomy Position: A Case Report
Se-Hwan Lee1,2, Hong-Pil Hwang3, Sun-Jung Yoon1,2
1Department of Orthopedic Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea.
Medicina (Kaunas, Lithuania)
|October 27, 2022
Summary
Compartment syndrome causing sciatic neuropathy after prolonged lithotomy surgery is rare. Early surgical decompression effectively treated this condition, improving motor function and reducing pain.
Area of Science:
- Neurology
- Surgical Innovation
- Medical Case Study
Background:
- Compressive nerve injuries are common complications of the lithotomy position during surgery.
- Sciatic neuropathy resulting from compartment syndrome after prolonged lithotomy is a rare occurrence, often leading to misdiagnosis.
Observation:
- A 56-year-old male developed left leg paresthesia and motor deficits after a 16-hour surgery in the lithotomy position.
- Physical examination revealed severe pain and weakness in ankle and toe movement (grade 1).
- Imaging confirmed ischemic changes and sciatic nerve compression by a well-leg holder in the distal thigh.
Findings:
- Open decompression of the sciatic nerve and debridement of necrotic tissue were performed.
- Immediate pain relief was observed post-surgery.
- Significant improvement in motor function for ankle and toe dorsiflexion (grade 4) was noted.
Implications:
- Early surgical intervention for confirmed sciatic nerve compression in lithotomy-induced compartment syndrome can minimize neurological deficits.
- This case highlights the importance of considering surgical decompression when conservative treatments fail.
- Prompt diagnosis and treatment are crucial for favorable outcomes in rare surgical complications.
