nerve injury

Background

Anatomy

Pelvis Anatomy

 

Pelvis is a true ring

- any anterior fracture must have a posterior injury as well

- integrity of the posterior sacroiliac complex is key

 

Bony Anatomy

 

2 innominate bones + sacrum

Symphysis pubis < 5mm

SI joint 2-4 mm

 

Nerve Injury

Epidemiology

 

Primary THR 1%

Revision THR 3%

DDH  5%

 

Sciatic nerve 90% of nerve palsy

 

Other

- femoral nerve

- CPN

- ulna / radial nerve from positioning

 

Aetiology

 

Direct 

 

Laceration

- exposure / sciatic and superior gluteal nerve

- drill reamer / obturator nerve

- spike of cement / obturator nerve

Arthroscopy

IndicationAnkle Arthroscopy

 

Diagnostic

 

Pain / Stiffness / Locking

Instability

- exclude OCD

Assess syndesmosis

 

Therapeutic

 

Synovitis

Osseous lesions / Tibiotalar impingement spurs

Osteochondral defects