Humans ; Sciatic Neuropathy/etiology* ; Arthroplasty, Replacement, Hip/adverse effects* ; Peripheral Nerve Injuries/etiology* ; Sciatic Nerve/injuries*

Bilateral hip dislocation rarely occurs. In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic accident is reported. Both hips were emergently reduced under general anaesthesia. Acetabular reconstruction was done bilaterally due to the unstable hips. The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty. The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was augmented by tendon transfer. Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time. To the best of our knowledge, this kind of injury has not been reported in the English language literature.
Accidents, Traffic ; Hip Dislocation ; complications ; Hip Fractures ; complications ; Humans ; Male ; Middle Aged ; Osteonecrosis ; etiology ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; etiology

A 77-year-old Chinese female patient presented with acute onset of left lower limb paraesthesia and weakness after she received an intramuscular injection for pain relief in the gluteal region. Magnetic resonance (MR) imaging of her lumbosacral spine and sacral plexus was performed. The MR imaging findings are reviewed and discussed.
Aged ; Female ; Humans ; Iatrogenic Disease ; Injections, Intramuscular ; adverse effects ; Magnetic Resonance Imaging ; Sciatic Neuropathy ; diagnosis ; etiology

Female ; Humans ; Mesothelioma ; pathology ; Middle Aged ; Neoplasm Metastasis ; Peripheral Nervous System Neoplasms ; secondary ; Radiography ; Sciatic Neuropathy ; diagnosis ; diagnostic imaging ; etiology

Aged ; Aged, 80 and over ; Arthroplasty ; methods ; Hip Joint ; surgery ; Hip Prosthesis ; adverse effects ; Humans ; Male ; Nerve Compression Syndromes ; etiology ; Sciatic Neuropathy ; etiology

Biomechanical Phenomena ; Child ; Exercise ; physiology ; Female ; Humans ; Leg ; Muscle, Skeletal ; injuries ; physiology ; Peripheral Nervous System Diseases ; Sciatic Neuropathy ; diagnosis ; etiology ; Thigh

OBJECTIVETo summarize surgical treatments and their corresponding curative effects on sciatic nerve injuries.

METHODSSurgical treatments on sciatic nerve injury were performed in 28 patients from January 1990 to July 2000. The treatments included neurolysis, neurolysis plus partial nerve anastomosis, nerve anastomosis and nerve transplantation. The curative effect was evaluated according to Sunderland criteria.

RESULTSOf 28 cases, 22 patients were followed up with a follow-up period of 13 months to 5 years (average 30 months). Of 22 nerves, 7 were excellent, 5 good, 7 fair and 3 poor, with an excellence rate of 54.5%.

CONCLUSIONSThe fair results of sciatic nerve injury are related to its structural character. Surgical exploration should be performed if nerve function does not recover 3 months after primary operation and if Tinel's sign and electromyogram show no signs of nerve regeneration. Electrophysiological monitoring in the operation is useful in electing surgical methods and predicting the results of nerve anastomosis.

Adolescent ; Adult ; Anastomosis, Surgical ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Nerve Regeneration ; physiology ; Neurosurgical Procedures ; methods ; Recovery of Function ; Retrospective Studies ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; etiology ; surgery ; Treatment Outcome

It has been reported that extracellular signal-regulate kinase (ERK) is involved in the modulation of nociceptive information and central sensitization produced by intense noxious stimuli and/or peripheral tissue inflammation. Few studies have explored the relationship between ERK and cAMP response-element binding protein (CREB) in neuropathic pain after nerve injury, such as chronic constriction injury (CCI) of the sciatic nerve. In the present study, CCI model was employed to investigate the activation of ERK on the expression of phosphorylated CREB (pCREB) in chronic neuropathic pain. Lumbar intrathecal catheters were chronically implanted in male Sprague-Dawley rats. The left sciatic nerve was loosely ligated proximal to the sciatica's trifurcation at around 1.0- mm intervals with 4-0 silk suture. Mitogen-activated protein kinase kinase (MEK) inhibitor U0126 and phosphorothioate-modified antisense oligonucleotides (ODN) were intrathecally administered one day before and three consecutive days after CCI. Thermal and mechanical nociceptive thresholds were assessed with the paw withdrawal lantency (PWL) to radiant heat and von Frey filaments respectively. The expression of pCREB and Fos were assessed by both Western blot and immunohistochemical analysis. The results showed that intrathecal injection of U0126 or ERK antisense ODN attenuated significantly CCI-induced mechanical and thermal hyperalgesia. Correlating with behavior results, the injection also markedly suppressed the increase of CCI-induced pCREB and c-Fos expression. The results obtained suggest that CREB participates in the pERK-mediated neuropathic pain.
Animals ; Cyclic AMP Response Element-Binding Protein ; metabolism ; physiology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; physiology ; Male ; Pain ; etiology ; metabolism ; physiopathology ; Phosphorylation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Neuropathy ; metabolism ; physiopathology ; Spinal Cord ; metabolism ; physiopathology

The present study is to investigate whether the extracellular signal-regulated kinase (ERK) and cAMP response element binding protein (CREB) signaling pathway contributes to the initiation of chronic constriction injury (CCI)-induced neuropathic pain in rats. Mechanical allodynia was assessed by measuring the hindpaw withdrawal threshold in response to a calibrated series of von Frey hairs. Thermal hyperalgesia was assessed by measuring the latency of paw withdrawal in response to a radiant heat source. The expressions of phosphor-ERK (pERK) and phosphor-CREB (pCREB) were examined using Western blot analysis and immunohistochemistry. An early robust increase in the expression of pERK on the spinal cords ipsilateral to injury was observed on day 1 after CCI, when the CCI-induced behavioral hypersensitivity had not developed yet. Moreover, the upregulation of pERK expression in ipsilateral spinal cord was associated with the increase in pCREB expression in bilateral spinal cord. Intrathecal administration of mitogen-activated protein kinase kinase (MEK) inhibitor U0126 before CCI can efficiently block and delay the CCI-induced mechanical allodynia and thermal hyperalgesia. These data suggest that activation of ERK and CREB in the spinal cord contributes to the initiation of peripheral nerve injury-induced pain hypersensitivity, and an early intervention strategy should be proposed.
Animals ; Butadienes ; pharmacology ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Enzyme Inhibitors ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Hyperalgesia ; etiology ; physiopathology ; prevention & control ; Male ; Nitriles ; pharmacology ; Pain ; etiology ; physiopathology ; prevention & control ; Peripheral Nerve Injuries ; complications ; metabolism ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Sciatic Neuropathy ; metabolism ; physiopathology ; Spinal Cord ; metabolism