PURPOSE To assess the relationship between the type of hip fracture-dislocation and nerve injury, the relationship between the treatment of hip fracture-dislocation and nerve recovery and the effectiveness of electromyography(EMG)-nerve conduction study(NCV) for the diagnosis of nerve injury and clinical result. MATERIALS AND METHODS We reviewed 8 cases associated with nerve injury of 52 cases which were diagnosed and treated for hip fracture-dislocation from March 1993 to December 1999 with an average follow up period 18.1 months. Mean age was 36.1 years. We assessed the diagnosis of nerve injury through physical exam at emergency room and follow up EMG-NCV. The clinical results of nerve recovery were evaluated according to the Clawson-Seddon classification. RESULT The cause of injury was motor vehicle accident in all cases. The outcome of the nerve injury was analyzed as 4 complete recovery, 3 partial recovery, 1 no recovery for 31 months follow up. The clinical result was analyzed as 7 satisfactory and 1 unsatisfactory. The latter was complete sciatic nerve injury, seemed to be recovered at follow up EMG-NCV but unsatisfactory for clinical result. CONCLUSION The nerve injury of the posterior hip fracture-dislocation was not rare and the rate of nerve injury was relatively good. The limitation as a clinical outcome was revealed in the EMG-NCV because one case which seemed to be recovered at follow up EMG-NCV was unsatisfactory for clinical result. In future, we think to require non-invasive, more reliable method for the diagnosis and follow up of the nerve injury and the study of the factor, can improve the nerve recovery.
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Traumatic Bilateral Anterior Hip Dislocation: A Case Report Sung-Taek Jung, Hyun-Jong Kim, Myung-Sun Kim, Young-Jin Kim, Sang-Kwan Cho Journal of the Korean Fracture Society.2008; 21(1): 62. CrossRef
The purpose of this study is to verify the clinical efficacy of unreamed nails compared to reamed nails. The cases of 31 parients in whom 32 fractures of the femoral shaft had been treated by intramedullary nailing with reamed or unreamed nails were prospectively reviewed. Reamed nailing was done for 17 cases, and unreamed nailing was done for 15 cases. The following results were obtained. 1. According to Winquist-Hansen classification, type 1 was 9 cases, type 2,3,4 were 4,2,2 cases 2. The average operation time was 70.5 minutes in reamed group, and 62.5 minutes in unreamed group(p-value=0.638). the average bleeding amount was 450ml in reamed group, and 218ml in unreamed group(p-value=0.000). 3. The mean times to partial weight bearing and full weight bearing were 4.4 weeks, 7.7 weeks in reamed group retrospectively, and 7.2 weeks, 13.7 weeks in unreamed group(p-walue=0.039,0.002). 4. The mean union time was 15.2 weeks in reamed group, and 17.7 weeks in unreamed group(p-value=0.237). 5. According to Denker's functional classification, 15 cases were excellent, 1 case was satisfactory, 1 case was very poor in reamed group, and 13 cases were wxcellent, 1 case was satisfactory, 1 case was poor in unreamed group(p-value=0.545).
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Bursting Fracture of the Proximal Femur during Insertion of Unreamed Femoral Nail for Femur Shaft Fracture - A Case Report - Ji Wan Kim, Seong-Eun Byun, Won-Hyuk Oh, Jung Jae Kim Journal of the Korean Fracture Society.2010; 23(2): 227. CrossRef