切换至 "中华医学电子期刊资源库"
高级检索
中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 105 -108,72. doi: 10.3877/cma.j.issn.1674-134X.2019.01.019

所属专题： 文献；

综述

人工全髋关节置换术后神经损伤
安庆1, 刘国雄2, Bikash Kumar Sah2, 周霖2, 庹伟2, 曹洪3,†()   
  1. 1. 442000　十堰，湖北医药学院；236700　亳安，利辛县人民医院骨科
    2. 442000　十堰，湖北医药学院；442000　十堰市人民医院（湖北医药学院附属人民医院）创伤骨科
    3. 442000　十堰市人民医院（湖北医药学院附属人民医院）创伤骨科
  • 收稿日期:2017-06-26 出版日期:2019-02-01
  • 通信作者: 曹洪
  • 基金资助:
    国家自然科学基金资助项目(81602867); 湖北省自然科学基金面上项目(2018CFB524); 湖北省教育厅科学研究计划指导性项目(B2018110)

Nerve injury after total hip arthroplasty

Qing An1, Guoxiong Liu2, Bikash Kumar Sah2, Lin Zhou2, Wei Tuo2, Hong Cao3,†()   

  1. 1. Hubei University of Medicine, Shiyan 442000, China; Department of Orthopedic Surgery, Renmin Hospital, Boan 236700, China
    2. Hubei University of Medicine, Shiyan 442000, China; Department of Orthopedic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
    3. Department of Orthopedic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
  • Received:2017-06-26 Published:2019-02-01
  • Corresponding author: Hong Cao
  • About author:
    Corresponding author: Cao Hong, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

安庆, 刘国雄, Bikash Kumar Sah, 周霖, 庹伟, 曹洪. 人工全髋关节置换术后神经损伤[J]. 中华关节外科杂志(电子版), 2019, 13(01): 105-108,72.

Qing An, Guoxiong Liu, Bikash Kumar Sah, Lin Zhou, Wei Tuo, Hong Cao. Nerve injury after total hip arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(01): 105-108,72.

神经损伤是人工全髋关节置换术后并发症之一，可引起严重的损害，甚至会导致患者终身的残疾。神经损伤后恢复缓慢，部分患者神经系统功能可能终生都无法恢复正常，这将严重影响人工全髋关节置换术后患者的预后及生活质量。因此，全髋关节置换术后的神经损伤常常引起法律诉讼。骨关节科医生必须予以高度重视。本文对髋关节置换术后神经损伤的原因及造成神经损伤的高风险因素进行分析，为减少人工全髋关节置换术后神经损伤的发生提供指导。

关键词: 关节成形术, 髋, 外周神经损伤

Nerve injury is one of the complications following total hip arthroplasty(THA), it may cause serious damage to the patient. Even, some patients may be left with severe disability. Recovery from a nerve injury can be very slow, and a part of nerve injuries, whether complete or incomplete, never fully resolved. This may cause difficulty with the post-operative rehabilitation, and the life of the patient. As so, nerve injury is a frequent cause of malpractice lawsuits after THA. Surgeons should pay more attentions to this devastating complication. The potential etiologies and the risk factors of nerve lesion were analyzed in this review, for the purpose of providing guidance for the reduction of nerve injury after total hip replacement.

Key words: Arthroplasty, Hip, Peripheral nerve injury
[1]
Oldenburg M, Muller R T. The frequency, prognosis and significance of nerve injuries in total hip arthroplasty[J]. Int Orthop, 1997, 21(1):1-3.
[2]
Yang IH. Neurovascular injury associated with hip arthroplasty[J]. Hip Pelvis, 2014, 26(2):74-78
[3]
Schmalzried TP, Noordin S, Amstutz HC. Update on nerve palsy associated with total hip replacement[J]. Clin Orthop Relat Res, 1997, (344): 188-206.
[4]
Farrell CM, Springer BD, Haidukewych GJ, et al. Motor nerve palsy following primary total hip arthroplasty[J]. J Bone Joint Surg Am, 2005, 87(12): 2619-2625.
[5]
Dietze S, Perka C, Baecker H. Blood vessel and nerve damage in total hip arthroplasty[J]. Orthopade, 2014, 43(1):64-69.
[6]
Johanson NA, Pellicci PM, Tsairis P, et al. Nerve injury in total hip arthroplasty[J]. Clin Orthop Relat Res, 1983, (179): 214-222.
[7]
Upadhyay A, York S, Macaulay W, et al. Medical malpractice in hip and knee arthroplasty[J]. J Arthroplasty, 2007, 22(6, 2): 2-7.
[8]
王辉．坐骨神经损伤的临床应用解剖分析[J]．中国实用神经疾病杂志，2015，18(24):101-102.
[9]
Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence: a review[J]. Clin Anat, 2010, 23(1): 8-17.
[10]
Gogus A, Ozturk C, Sirvanci M, et al. Femoral nerve palsy due to iliacus hematoma occurred after primary total hip arthroplasty[J]. Arch Orthop Trauma Surg, 2008, 128(7): 657-660.
[11]
Ng J, Marson BA, Broodryk A. Foot drop following closed reduction of a total hip replacement[J/OL]. BMJ case reports, 2016, 22: pii: bcr2016215010. doi: 10.1136/bcr-2016-215010.
[12]
徐朝阳，任彦红，涂丽莉，等．股神经周围筋膜及其毗邻结构的解剖[J]．解剖学报，2013，44(3):364-367.
[13]
Brown GD, Swanson EA, Nercessian OA. Neurologic injuries after total hip arthroplasty[J]. Am J Orthop (Belle Mead NJ), 2008, 37(4): 191-197.
[14]
Fox AJ, Bedi A, Wanivenhaus F, et al. Femoral neuropathy following total hip arthroplasty Review and management guidelines[J]. Acta Orthop Belg, 2012, 78(2): 145-151.
[15]
Liman J, von Gottberg P, Bahr M, et al. Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement: a case report[J/OL]. J Med Case Rep, 2011, 18(5):190. doi: 10.1186/1752-1947-5-190.
[16]
刘建寅，郭强，李庆泰，等.26例股神经损伤的临床治疗分析[J]．中华显微外科杂志，2006，29(2):95-96.
[17]
Wasielewski RC, Crossett LS, Rubash HE. Neural and vascular injury in total hip arthroplasty[J]. Orthop Clin North Am, 1992, 23(2): 219-235.
[18]
Fricker R M, Troeger H, Pfeiffer K M. Obturator nerve palsy due to fixation of an acetabular reinforcement ring with transacetabular screws. A case report [J]. J Bone Joint Surg Am, 1997, 79(3):444-446.
[19]
Ramesh M, O’Byrne JM, McCarthy N, et al. Damage to the superior gluteal nerve after the Hardinge approach to the hip[J]. J Bone Joint Surg Br, 1996, 78(6):903-906.
[20]
Dehart MM, Riley LJ. Nerve injuries in total hip arthroplasty[J]. J Am Acad Orthop Surg, 1999, 7(2): 101-111.
[21]
Park JH, Hozack B, Kim P, et al. Common peroneal nerve palsy following total hip arthroplasty: prognostic factors for recovery[J/OL]. J Bone Joint Surg Am, 2013, 95A(9): e55. doi: 10.2106/JBJS.L.00160.
[22]
Wilson JN, Scales JT. The Stanmore metal on metal total hip prosthesis using a three pin type cup. A follow-up of 100 arthroplasties over nine years[J]. Clin Orthop Relat Res, 1973, 9(95):239-249.
[23]
Darmanis S, Pavlakis D, Papanikolaou A, et al. Neurovascular injury during primary total hip arthroplasty caused by a threaded acetabulum cup[J]. J Arthroplasty, 2004, 19(4):520-524.
[24]
Simmons CJ, Izant TH, Rothman RH, et al. Femoral neuropathy following total hip arthroplasty. Anatomic study, case reports, and literature review[J]. J Arthroplasty, 1991, 6 Suppl:S57-S66.
[25]
Weber ER, Daube JR, Coventry MB. Peripheral neuropathies associated with total hip arthroplasty[J]. J Bone Joint Surg Am, 1976, 58(1): 66-69.
[26]
Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty[J]. Acta Orthop Scand, 1980, 51(3): 531-534.
[27]
Navarro RA, Schmalzried TP, Amstutz HC, et al. Surgical approach and nerve palsy in total hip arthroplasty[J]. J Arthroplasty, 1995, 10(1): 1-5.
[28]
邓磊，刘沂．全髋关节置换术的并发症及其处理(七)全髋关节置换后的神经并发症[J]．中国骨肿瘤骨病，2005，4(1):40-44.
[29]
Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty[J]. Clin Orthop Relat Res, 1987, (218): 136-141.
[30]
Weale AE, Newman P, Ferguson IT, et al. Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study[J]. J Bone Joint Surg Br, 1996, 78(6):899-902.
[31]
赵力，王振虎，赵岩，等．骨牵引在成人DDH全髋关节置换术中预防坐骨神经麻痹的应用[J]．中国医药导刊，2017，19(1):7-8.
[32]
Rasmussen TJ, Black DL, Bruce RP, et al. Efficacy of corticosomatosensory evoked potential monitoring in predicting and/or preventing sciatic nerve palsy during total hip arthroplasty[J]. J Arthroplasty, 1994, 9(1): 53-61.
[33]
Kennedy WF, Byrne TF, Majid HA, et al. Sciatic nerve monitoring during revision total hip arthroplasty[J]. Clinical orthopaedics and related research [J]. Clin Orthop Relat Res, 1991, (264): 223-227.
[34]
陈艺，叶劲，白波，等．复杂髋关节手术中应用电生理监测技术预防下肢周围神经损伤[J/CD]．中华关节外科杂志(电子版)，2013，7(5):622-626.
[35]
陈涛，杨春喜．人工全髋关节置换术治疗Crowe Ⅳ型先天性髋关节发育不良截骨术的研究进展[J]．中国修复重建外科杂志，2015，29(4):444-447.
[36]
吴健，王兵，吴玉玲，等．粗隆下截骨结合Zweymuller假体全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良[J/CD]．中华关节外科杂志(电子版)，2014，08(5):608-612.
[37]
沈晓峰，姜宏．全髋关节置换术后神经损伤的原因及预防措施[J]．中医正骨，2013，25(1):46-48.
[38]
Su EP. Post-operative neuropathy after total hip arthroplasty[J]. Bone Joint J, 2017, 99-B(1 Suppl): 46-49.
[39]
Wooten SL, Mclaughlin RE. Iliacus hematoma and subsequent femoral nerve palsy after penetration of the medical acetabular wall during total hip arthroplasty. Report of a case [J]. Clin Orthop Relat Res, 1984, (191): 221-223.
[40]
Zappe B, Glauser PM, Majewski M, et al. Long-term prognosis of nerve palsy after total hip arthroplasty：results of two-year-follow-ups and long-term results after a mean time of 8 years[J]. Arch Orthop Trauma Surg, 2014, 134(10): 1477-1482.
[41]
Schmalzried TP, Amstutz HC, Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis[J]. J Bone Joint Surg Am, 1991, 73(7):1074-1080.
[1] 周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[2] 林文, 王雨萱, 许嘉悦, 王矜群, 王睿娜, 何董源, 樊沛. 人工关节置换登记系统的研究进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 834-841.
[3] 闫文, 谢兴文, 顾玉彪, 雷宁波, 马成, 于文霞, 高亚雄, 张磊. 微小RNA与全膝关节置换术后深静脉血栓的研究进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 842-846.
[4] 贺敬龙, 尚宏喜, 郝敏, 谢伟, 高明宏, 孙炜, 刘安庆. 重度类风湿关节炎患者行多关节置换术的临床手术疗效[J]. 中华关节外科杂志(电子版), 2023, 17(06): 860-864.
[5] 孟繁宇, 周新社, 赵志, 裴立家, 刘犇. 侧位直接前方入路髋关节置换治疗偏瘫肢体股骨颈骨折[J]. 中华关节外科杂志(电子版), 2023, 17(06): 865-870.
[6] 王宏宇. 固定与活动平台假体在全膝关节置换术中的应用价值[J]. 中华关节外科杂志(电子版), 2023, 17(06): 871-876.
[7] 李善武, 叶永杰, 王兵, 王子呓, 银毅, 孙官军, 张大刚. 胫骨高位截骨与单髁置换的早期疗效比较[J]. 中华关节外科杂志(电子版), 2023, 17(06): 882-888.
[8] 李辉, 吴奇, 张子琦, 张晗, 王仿, 许鹏. 日间全膝关节置换术早期疗效及标准化流程探索[J]. 中华关节外科杂志(电子版), 2023, 17(06): 889-892.
[9] 中华医学会骨科学分会关节外科学组, 广东省医学会骨质疏松和骨矿盐疾病分会, 广东省佛山市顺德区第三人民医院. 中国髋部脆性骨折术后抗骨质疏松药物临床干预指南(2023年版)[J]. 中华关节外科杂志(电子版), 2023, 17(06): 751-764.
[10] 金鑫, 谢卯, 刘芸, 杨操, 杨述华, 许伟华. 个性化股骨导向器辅助初次全髋关节置换的随机对照研究[J]. 中华关节外科杂志(电子版), 2023, 17(06): 780-787.
[11] 邓华梅, 袁札根, 曾德荣, 潘珊珊, 张葆青, 欧爱华, 曹学伟. 全膝关节置换术中气压止血带应用效果与影响因素分析[J]. 中华关节外科杂志(电子版), 2023, 17(06): 788-794.
[12] 张思平, 刘伟, 马鹏程. 全膝关节置换术后下肢轻度内翻对线对疗效的影响[J]. 中华关节外科杂志(电子版), 2023, 17(06): 808-817.
[13] 中华医学会骨科分会关节学组. 中国髋、膝关节置换日间手术围手术期管理专家共识[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 321-332.
[14] 丁晨梦, 胡雪慧, 闫沛, 程乔. 髋部骨折术后患者居家康复体验质性研究的Meta整合[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 365-372.
[15] 李岩松, 李涛, 张元鸣飞, 李志鹏, 周谋望. 头戴式虚拟现实设备辅助全膝关节置换术后康复的初步研究[J]. 中华临床医师杂志(电子版), 2023, 17(06): 676-681.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号