Femoral nerve palsy after pelvic fracture treated with INFIX: a case series.

Abstract:

OBJECTIVE:The treatment of some pelvic injuries has evolved recently to include the use of a subcutaneous anterior pelvic fixator (INFIX). We present 8 cases of femoral nerve palsy in 6 patients after application of an INFIX to highlight this potentially devastating complication to pelvic surgeons using this technique and discuss how it might be avoided in the future. DESIGN:Retrospective chart review. Case series. SETTING:Five level 1 and 2 trauma centers, tertiary referral hospitals. PATIENTS/PARTICIPANTS:Six patients with anterior pelvic ring injury treated with an INFIX who experienced 8 femoral nerve palsies (2 bilateral). INTERVENTION:Removal of internal fixator, treatment for femoral nerve palsy. MAIN OUTCOME MEASUREMENTS:Clinical and electromyographic evaluation of patients. RESULTS:All 6 patients with a total of 8 femoral nerve palsies had their INFIX removed. Variable resolution of the nerve injuries was observed. CONCLUSIONS:Application of an INFIX for the treatment of pelvic ring injury carries a potentially devastating risk to the femoral nerve(s). Despite early implant removal after detection of nerve injury, some patients had residual quadriceps weakness, disturbance of the thigh's skin sensation, and/or gait disturbance attributable to femoral nerve palsy at the time of early final follow-up. LEVEL OF EVIDENCE:Therapeutic level IV. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

authors

Hesse D,Kandmir U,Solberg B,Stroh A,Osgood G,Sems SA,Collinge CA

doi

10.1097/BOT.0000000000000193

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

138-43

issue

3

eissn

0890-5339

issn

1531-2291

journal_volume

29

pub_type

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