Femoral Nerve

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Thomas P Sculco - One of the best experts on this subject based on the ideXlab platform.

Mark D. Stringer - One of the best experts on this subject based on the ideXlab platform.

  • Iatrogenic Femoral Nerve injury: a systematic review
    Surgical and Radiologic Anatomy, 2011
    Co-Authors: Abigail E. Moore, Mark D. Stringer
    Abstract:

    Purpose Iatrogenic Femoral Nerve injury is a recognized complication of abdominal and pelvic surgery. It causes distress and disability and may lead to permanent motor and/or sensory sequelae. The aim of this systematic review was to explore the contemporary spectrum of this injury reported in the literature. Methods A systematic review of iatrogenic Femoral Nerve injuries reported between 2000 and October 2010 was undertaken using the electronic databases Medline, PubMed, Cochrane Library, and Google Scholar. The context, frequency, mechanism of injury, and outcome were recorded. Relevant clinical and anatomical literature was reviewed to provide an overview of the surgical anatomy. Results Iatrogenic Femoral Nerve injury is not rare, occurring as a complication of common abdominal, pelvic, and orthopedic operations and after Femoral Nerve blocks and Femoral artery puncture. Mechanisms of injury are diverse and include direct trauma and ischemia from retraction or stretching of the Nerve. Variant anatomy is very rarely the source of the problem. Although the prognosis in most cases is good some affected patients require Nerve repair or grafting and some are left with permanent residual neurologic deficits. Conclusions A wider awareness of this complication, particularly the context in which it may occur, together with an appropriate understanding of the anatomy of the Femoral Nerve may help to reduce the frequency of this distressing and disabling iatrogenic complication.

  • iatrogenic Femoral Nerve injury a systematic review
    Surgical and Radiologic Anatomy, 2011
    Co-Authors: Abigail E. Moore, Mark D. Stringer
    Abstract:

    Purpose Iatrogenic Femoral Nerve injury is a recognized complication of abdominal and pelvic surgery. It causes distress and disability and may lead to permanent motor and/or sensory sequelae. The aim of this systematic review was to explore the contemporary spectrum of this injury reported in the literature.

Jacques T Yadeau - One of the best experts on this subject based on the ideXlab platform.

William L Healy - One of the best experts on this subject based on the ideXlab platform.

  • complications of Femoral Nerve block for total knee arthroplasty
    Clinical Orthopaedics and Related Research, 2010
    Co-Authors: Sanjeev Sharma, Richard Iorio, Lawrence M Specht, Sara Davieslepie, William L Healy
    Abstract:

    Preemptive and multimodal pain control protocols have been introduced to enhance rehabilitation after total knee arthroplasty (TKA). We determined the complication rate associated with preoperative Femoral Nerve block (FNB) for TKA. Among 1018 TKA operations, we performed 709 FNBs using a single-injection technique into the Femoral Nerve sheath and confirming position with Nerve stimulation before induction. After TKA, weightbearing as tolerated was initiated using a walker or crutches on postoperative Day 1. Twelve patients (1.6%) treated with FNB sustained falls, three (0.4%) of whom underwent reoperations. Five patients had postoperative Femoral neuritis, which may have been secondary to the block. One patient had new onset of atrial fibrillation after FNB, and the TKA was postponed. Femoral Nerve block before TKA is not a harmless intervention. We recommend postoperative protocols be modified for patients who have FNB to account for decreased quadriceps function in the early postoperative period, which can lead to falls.

Dae Suk Yang - One of the best experts on this subject based on the ideXlab platform.

  • Two continuous Femoral Nerve block strategies after TKA
    Knee Surgery Sports Traumatology Arthroscopy, 2011
    Co-Authors: Won Sik Choy, Dae Suk Yang
    Abstract:

    Purpose The purposes of this study were to compare the pain score, systemic opioid consumption, and range of motion (ROM) between the group where the use of continuous Femoral Nerve block (CFNB) was discontinued on postoperative day 3 (POD 3) and the group where it was discontinued on POD 7 within an established clinical pathway for postoperative recovery after total knee arthroplasty (TKA) and to assess the treatment-related side effects and complications, as well as the functional status of these two groups of patients at 2 years after surgery. Methods This prospective, randomized, double-blinded trial compared the analgesic efficacy and the functional outcomes between group A ( n  = 30) where continuous Femoral Nerve block was performed until POD 3 (discontinued prior to the initiation of range of motion (ROM) exercises) and group B ( n  = 33), where the continuous Femoral Nerve block was performed until POD 7 (discontinued during the ROM exercise) after TKA. Results The resting pain scores of group B were lower than those of group A but there was no significant difference between the two groups (n.s., P  = 0.387). However, the peak pain scores during ROM exercise, beginning on POD3 through to POD14, were significantly lower in group B than in group A ( P  = 0.001). The cumulative morphine IV-PCA requirements through the POD 2 were similar in the two groups (n.s., P  = 0.811). However, the cumulative oral oxycodone consumption during hospitalization was significantly lower in group B than in group A, P  

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