Total abdominal hystrectomy is the most common surgery of Gynecology. It's complication are taken very important. Although neuropathy, especially femoral nerve injury, is rare, recently we have experienced a case of femoral neuropathy after total abdominal hystrectomy. We present this case with a brief review of literature.
Femoral Nerve* ; Femoral Neuropathy ; Gynecology

No abstract available.
Femoral Nerve* ; Humans ; Ossification, Heterotopic*

A few cases of femoral neuropathy that were developed after renal transplantation have been reported in western literature. The possible causes of this neuropahty that discussed in recent studies are compression of nerve by self-retaining retractor during operation, ischemia of femoral nerve by iliac muscle hematoma etc. We experienced one case of femoral nerve neuropathy after right iliac fossa renal transplantation that developed at first postoperative day without definitive etiology in all study. It was improved symptomatically after 2 weeks of postoperative day, so we reported this case with brief review of the literatures.
Femoral Nerve ; Femoral Neuropathy* ; Hematoma ; Ischemia ; Kidney Transplantation*

OBJECTIVE: Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. METHODS: Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. RESULTS: The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. CONCLUSION: The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.
Cadaver ; Femoral Artery ; Ligaments ; Obturator Nerve* ; Spine

Sciatic nerve palsy is the most common nerve injury associated with acetabular fracture and dislocation, but femoral nerve injury is known to be very rare because of relative protected position of nerve between the iliacus and psoas muscle, and as far as we know only one report was noted in English about combined femoral and sciatic nerve injury associated with acetabular fracture and dislocation, so we hereby report a case of combined femoral and sciatic nerve palsy associated with acetabular fracture and dislocation.
Acetabulum* ; Dislocations* ; Femoral Nerve ; Psoas Muscles ; Sciatic Nerve* ; Sciatic Neuropathy*

The purpose of this study was to classify the spinal nerve compositions of the terminal branches of the lumbosacral plexus, providing data of their participating quantities. Twenty-five sides of the lumbosacral plexus extracted from Korean adult cadavers were used in this study. The iliohypogastric nerve was mostly arisen from L1 (88.2%, thickness L1 0.7 mm). The ilioinguinal nerve was arisen from only L1 (100%, thickness L1 0.6 mm). The genitofemoral nerve was commonly arisen from L1 and L2 (62.5%, thickness L1 0.6 mm, L2 0.7 mm). The lateral femoral cutaneous nerve was classified into 4 types, and the most common type was that L2 and L3 composed this nerve (56.0%, thickness L2 0.8 mm, L3 0.4 mm). The femoral nerve was classified into 2 types, and it was usually composed of L2, L3 and L4 (88.0%, thickness L2 1.4 mm, L3 2.7 mm, L4 2.3 mm). The obturator nerve was arisen from L2, L3 and L4 in all cases (100%, thickness L2 0.5 mm, L3 1.3 mm, L4 1.1 mm). The common fibular component of sciatic nerve was mostly arisen from L4, L5, S1 and S2 (84.0%, thickness L4 0.9 mm, L5 2.0 mm, S1 2.1 mm, S2 1.2 mm). The tibial component of sciatic nerve was mainly arisen from L4, L5, S1 and S2 (96.0%, thickness L4 0.9 mm, L5 1.9 mm, S1 2.2 mm, S2 1.9 mm). The superior gluteal nerve was commonly derived from L4, L5 and S1 (56.0%, thickness L4 0.7 mm, L5 1.1 mm, S1 0.9 mm). The inferior gluteal nerve was comprised of L5, S1 and S2 in several cases (54.2%, thickness L5 0.9 mm, S1 1.3 mm, S2 0.8 mm). The posterior femoral cutaneous nerve was composed of S1 and S2 in higher freqeuncy (40.0%, thickness S1 0.9 mm, S2 1.0 mm, S3 0.8 mm). The perforating cutaneous nerve was arisen from S2 and S3 in higher frequency (56.0%, thickness S1 0.7 mm, S2 0.9 mm, S3 1.1 mm). The pudendal nerve was derived from S3 in many cases (52.9%, thickness S3 1.5 mm). These anatomical results may be helpful to predict the spinal nerve root lesions of the lumbosacral plexus.
Adult ; Cadaver ; Femoral Nerve ; Humans ; Lumbosacral Plexus ; Obturator Nerve ; Pudendal Nerve ; Sciatic Nerve ; Spinal Nerve Roots ; Spinal Nerves

PURPOSE: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. MATERIALS AND METHODS: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. RESULTS: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. CONCLUSION: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.
Anesthesia ; Animals ; Ankle ; Fees and Charges ; Femoral Nerve ; Humans ; Nerve Block ; Pain, Postoperative ; Sciatic Nerve ; Tourniquets

Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.
Anesthesia, Local ; Femoral Nerve ; Foot* ; Humans ; Leg* ; Nerve Block* ; Sciatic Nerve ; Skin Transplantation* ; Tissue Donors ; Ulcer*

OBJECTIVETo observe the effect of femoral and sciatic nerve block on tourniquet reaction and postoperative pain during total knee arthroplasty (TKA).

METHODSTotally 60 patients scheduled for TKA were equally divided into two groups according to the random number table (n=30):femoral nerve block (F) group and femoral and sciatic nerve block (SF) group. The changes of mean arterial pressure (MAP) and heart rate (HR) in each group were recorded at the tourniquet inflated immediately (T1),30 minutes (T2),60 minutes (T3),90 minutes (T4),loose tourniquet (T5) and post extubation (T6). The total amount of anesthetics drugs propofol and remifentanil were calculated. The pain score after extubation and the location of pain were recorded.

RESULTSMAP and HR in group SF were steady at T1-T6 (all P>0.05). Compared with group SF,MAP in group F were significantly increased at T2-T4 and T6 (all P<0.05),and the HR at T4 and T6 were significantly increased (all P<0.05). Compared with the group F,the total amount of propofol and remifentanil were significantly decreased in group SF (all P<0.05),and pain scores at rest and on movement were reduced (P<0.05);in addition,90% patients in group F complained of posterior popliteal pain.

CONCLUSIONFemoral nerve and sciatic nerve block applied in TKA can obviously inhibit the tourniquet reaction,keep hemodynamic stability,reduce the dosage of anesthetic drug,and relieve the postoperative pain.

Spontaneous hematomas of the iliacus muscle are rare lesions and these are seen in individuals receiving anticoagulation therapy or patients with blood dyscrasias such as hemophilia. It can cause femoral neuropathy and resultant pain and paralysis. Although there is no clear consensus for the treatment of femoral neuropathy from iliacus muscle hematomas, delays in the surgical evacuation of hematoma for decompression of the femoral nerve can lead to a prolonged or permanent disability. We report here on a rare case of a spontaneous iliacus muscle hematoma that caused femoral neuropathy in a patient who was taking warfarin for occlusive vascular disease and we discuss the treatment.
Consensus ; Decompression ; Femoral Nerve ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Humans ; Muscles ; Paralysis ; Vascular Diseases ; Warfarin