Meralgia paresthetica (MP) is a neuropathic pain caused by the entrapment of the lateral femoral cutaneous nerve (LFCN). There have been reports of MP following various surgeries; however, it has not yet been reported after hemorrhoid surgery. We report a case of bilateral MP after hemorrhoid surgery in a jack-knife position. The patient presented with pain, tightness, and a tingling sensation in the anterolateral aspect of both thighs. Ultrasonography-guided LFCN block was used for diagnosis and treatment, along with conservative management for 20 days with oral medication. One month later, the patient's symptoms had resolved completely. MP due to the jack-knife position may occur postoperatively in patients with predisposing risk factors such as obesity and diabetes mellitus, despite adequate padding and a shorter operating time.
Diabetes Mellitus ; Diagnosis ; Femoral Neuropathy ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Nerve Compression Syndromes ; Neuralgia ; Obesity ; Prone Position ; Risk Factors ; Sensation ; Thigh

Compressive femoral neuropathy is a disabling condition accompanied by difficulty in hip flexion and knee extension. It may result from retroperitoneal hematoma or bleeding, or from complications associated with pelvic, hip surgery, and renal transplants. A 55-year-old female with autosomal dominant polycystic kidney disease presented with proximal muscle weakness in lower extremities. The patient experienced recurrent renal cyst infection, with aggravated weakness during each event. Electromyography and nerve conduction study revealed bilateral femoral neuropathy. Computed tomography and magnetic resonance images were added to further identify the cause. As a result, a diagnosis of femoral neuropathy caused by enlarged polycystic kidney was made. Cyst infection was managed with antibiotics. Renal function was maintained by frequent regular hemodialysis. While avoiding activities that may increase abdominal pressure, rehabilitation exercises were provided. Motor strength in hip flexion and knee extension improved, and was confirmed via electrodiagnostic studies.
Anti-Bacterial Agents ; Diagnosis ; Electromyography ; Exercise ; Female ; Femoral Neuropathy* ; Hematoma ; Hemorrhage ; Hip ; Humans ; Knee ; Lower Extremity ; Middle Aged ; Muscle Weakness ; Neural Conduction ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant* ; Rehabilitation ; Renal Dialysis

Femur intramedullary nailing can be one of the most predictable procedures in orthopedic traumatology. The advantage of this method is that the fracture site does not have to be widely exposed for reduction, which can minimize soft tissue damage. For this reason, the incidence of complications related to hematoma has been rare. We experienced only one case of sciatic nerve palsy due to hematoma after intramedullary nailing; the patient was receiving an anticoagulant therapy. Therefore, we report this case with literature review.
Anticoagulants* ; Femoral Fractures ; Femur* ; Fracture Fixation, Intramedullary* ; Hematoma* ; Humans ; Incidence ; Methods ; Orthopedics ; Sciatic Nerve* ; Sciatic Neuropathy* ; Traumatology

No abstract available.
Femoral Neuropathy*

Treatment of femoral neuropathy caused by iliacus hematoma can be divided according to operative treatment and non-operative treatment. Recently, percutaneous drainage has been more popular because it is relatively simple, convenient, and less invasive. After warfarin overuse, a 71-year-old male patient visited the emergency room with femoral neuropathy caused by a left iliacus muscle hematoma measuring approximately 110x64 mm, 75x60 mm in size on coronal and sagittal computed tomography angiograhy. Without trauma, weakness of the left hip flexor and left knee extensor was noted with strength of 2/5 (poor) each. Immediate medical treatment using vitamin K and fresh frozen plasma was started and percutaneous drainage was performed. Two days after visiting the emergency room, neurological symptoms were improved and non-operative treatment was continued. Twenty four days after being hospitalized, the size of the hematoma was reduced to approximately 75x45 mm, 62x40 mm in size. Approximately three months after hospitalization, most of the hematoma was absorbed. After one year, mild atrphy of quadriceps and mild diffuse pain were noted, however, no other symptoms were observed.
Aged ; Drainage ; Emergency Service, Hospital ; Femoral Neuropathy* ; Hematoma* ; Hip ; Hospitalization ; Humans ; Knee ; Male ; Plasma ; Vitamin K ; Warfarin

Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femoral neuropathy associated with a patella fracture.
Adult ; Electromyography ; Female ; Femoral Nerve ; Femoral Neuropathy ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Muscle Weakness ; Paralysis ; Paresthesia ; Patella ; Peripheral Nervous System Diseases ; Walking

A 17-year-old male patient complained of acutely developed severe paresthesia, pain, and weakness of the right lower extremity. He fell to the ground during performance of hand-stand physical exercise. Despite administration of conservative treatment for two weeks in a private clinic, motor function of the hip flexor and knee extensor were measured as poor grade. EMG showed femoral nerve and lateral femoral cutaneous nerve injury. Findings on MRI and CT revealed a mass measuring 8x5x7 cm in the iliac fossa. After evacuation of the hematoma(400 cc), neurologic dysfunction and thigh circumference were fully recovered, compared with the contralateral side, after one and half year follow up. This condition rarely occurs in individuals without coagulopathy. We reported on a rare case of iliacus hematoma and femoral neuropathy treated by surgical decompression in a patient with no coagulopathy.
Adolescent ; Decompression, Surgical ; Exercise ; Femoral Nerve ; Femoral Neuropathy ; Follow-Up Studies ; Hematoma ; Hip ; Humans ; Knee ; Lower Extremity ; Male ; Neurologic Manifestations ; Paresthesia ; Thigh

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

Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9x5x4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.
Adolescent ; Decompression, Surgical ; Electromyography ; Femoral Neuropathy ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Leg ; Needles ; Nerve Compression Syndromes ; Neural Conduction ; Pelvic Bones ; Regeneration ; Thigh

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.
Female ; Femoral Neuropathy ; Fibroma ; Humans ; Hyperalgesia ; Leg ; Liposarcoma ; Lumbosacral Plexus ; Muscles ; Neuralgia ; Thigh