Femoral branch to obturator nerve transfer for restoration of thigh adduction following iatrogenic injury

2011 ◽  
Vol 114 (6) ◽  
pp. 1529-1533 ◽  
Author(s):  
Konstantinos Spiliopoulos ◽  
Ziv Williams
Keyword(s):  
Muscle Strength ◽  
Nerve Injury ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Management Strategies ◽  
Nerve Transfer ◽  
Obturator Nerve ◽  
Pelvic Surgery ◽  
Gynecological Malignancy ◽  
Normal Gait

Obturator nerve injury is a rare complication of pelvic surgery. A variety of management strategies have been reported, with conservative measures being the preferred treatment in most cases. While nerve transfer has become more commonly used for restoring brachial plexus injuries, it has rarely been applied to the lower extremities. To the authors' knowledge, this is the first report of an obturator nerve neurotization. A patient presented 7 months after an iatrogenic right obturator nerve palsy due to pelvic surgery for gynecological malignancy. She underwent a femoral branch to obturator nerve transfer to restore right thigh adduction. Ten months after the neurotization procedure, there was electromyographic evidence of almost complete obturator nerve reinnervation. At 1 year postoperatively, the patient had regained full muscle strength on thigh adduction and a normal gait. Nerve transfer could therefore be a good option in patients with obturator nerve injury whose symptoms fail to respond to conservative medical therapy.

Obturator Nerve Transfer to the Branch of the Tibial Nerve Innervating the Gastrocnemius Muscle for the Treatment of Sacral Plexus Nerve Injury

Neurosurgery ◽  
2015 ◽  
Vol 78 (4) ◽  
pp. 546-551 ◽  
Author(s):  
Gang Yin ◽  
Huihao Chen ◽  
Chunlin Hou ◽  
Jianru Xiao ◽  
Haodong Lin
Keyword(s):  
Nerve Injury ◽  
Gastrocnemius Muscle ◽  
Tibial Nerve ◽  
Nerve Transfer ◽  
Obturator Nerve ◽  
Surgical Reconstruction ◽  
Sacral Plexus ◽  
Medial Head ◽  
Anterior Branch ◽  
The Mean

Abstract BACKGROUND: Lower-limb function is severely impaired after sacral plexus nerve injury. Nerve transfer is a useful reconstructive technique for proximal nerve injuries. OBJECTIVE: To investigate the clinical effectiveness and safety of transferring the ipsilateral obturator nerve to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle to recover knee and ankle flexion. METHODS: From 2007 to 2011, 5 patients with sacral plexus nerve injury underwent ipsilateral obturator nerve transfer as part of a strategy for surgical reconstruction of their plexuses. The mean patient age was 31.4 years (range, 19-45 years), and the mean interval from injury to surgery was 5.8 months (range, 3-8 months). The anterior branch of the obturator nerve was coapted to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle by autogenous nerve grafting. RESULTS: Patient follow-up ranged from 24 to 38 months. There were no complications related to the surgery. Three patients recovered to Medical Research Council grade 3 or better in the medial head of the gastrocnemius muscle. Thigh adduction function was not affected in any patient. CONCLUSION: Knee and ankle flexion can be achieved by transferring the anterior branch of the obturator nerve to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle, which is useful for balance. This procedure can be used as a new method for treating sacral plexus nerve injury.

Obturator nerve injury: a rare complication of retropubic tension-free vaginal sling

2016 ◽  
Vol 27 (10) ◽  
pp. 1597-1599 ◽  
Author(s):  
Georgina Baines ◽  
Simon R. Jackson ◽  
Natalia Price
Keyword(s):  
Nerve Injury ◽  
Rare Complication ◽  
Obturator Nerve ◽  
Tension Free

Bilateral glossopharyngeal nerve palsy following tonsillectomy: a very rare and difficult complication of a common procedure

2015 ◽  
Vol 129 (4) ◽  
pp. 392-394 ◽  
Author(s):  
A Trinidade ◽  
C M Philpott
Keyword(s):  
Case Report ◽  
Soft Palate ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Management Strategies ◽  
Glossopharyngeal Nerve ◽  
Significant Morbidity ◽  
Common Procedure ◽  
Over Time

AbstractObjectives:Tonsillectomy is one of the most commonly performed otolaryngological procedures. Bilateral palsy of the glossopharyngeal nerve is an exceedingly rare complication that can result in significant morbidity. This case report aimed to raise awareness of this complication and outline management strategies.Case report:A 31-year-old woman who underwent routine tonsillectomy presented with progressive numbness of the palate, dysgeusia, xerostomia, paraesthesia of the tongue and the feeling of something in her throat within 2 weeks of surgery. She reported the post-operative onset of snoring. Examination revealed a symmetrically low, ‘dropped’ soft palate. Over time, her symptoms have lessened, but dysgeusia and snoring remain.Conclusion:The position of the glossopharyngeal nerve in the tonsillar bed makes it prone to injury during tonsillectomy, especially if ‘hot’ methods are used. Bilateral injury can result in significant morbidity that can be difficult to treat. Patients should be warned about this risk and care should be taken to minimise it.

760 Unilateral Isolated Hypoglossal Nerve Palsy After Shoulder Surgery: A Case Report

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Wei ◽  
D Karunaratne ◽  
C Sivaji
Keyword(s):  
Nerve Injury ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Rare Complication ◽  
Humeral Fracture ◽  
Complete Recovery ◽  
Cross Sectional ◽  
Hypoglossal Nerve Palsy ◽  
Cross Sectional Imaging ◽  
High Index Of Suspicion

Abstract Aim Hypoglossal nerve injury is a rare complication in anaesthetic and surgical practice with only a few cases worldwide. This report describes the pathophysiology of this condition and highlights the key managements steps and expected outcomes for clinicians and patients. Case An open reduction and internal fixation of a left humeral fracture was performed on a healthy female patient in her mid-fifties under general anaesthesia. Two hours post-operatively, she developed left sided tongue swelling and deviation with dysphagia and dysarthria. Urgent CT head and MRA scans showed no abnormalities, leading to a diagnosis of isolated left hypoglossal nerve injury. Neurology and SALT were both involved in her care, but she ultimately made a full functional recovery after six months without any specific intervention. Conclusions A clear history, examination and high index of suspicion are crucial in the diagnosis of a hypoglossal nerve palsy. Cross sectional imaging is necessary to exclude any intracranial lesions, but intervention is rarely required, and patients should expect a slow but complete recovery over a period of months.

Partial obturator nerve transfer for femoral nerve injury: A case report

2018 ◽  
Vol 23 (1) ◽  
pp. 202-204 ◽  
Author(s):  
Naoto Inaba ◽  
Kazuki Sato ◽  
Taku Suzuki ◽  
Takuji Iwamoto ◽  
Kensuke Ochi ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Injury ◽  
Femoral Nerve ◽  
Nerve Transfer ◽  
Obturator Nerve ◽  
Femoral Nerve Injury

Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽  
2021 ◽  
pp. 155894472098812
Author(s):  
J. Megan M. Patterson ◽  
Stephanie A. Russo ◽  
Madi El-Haj ◽  
Christine B. Novak ◽  
Susan E. Mackinnon
Keyword(s):  
Radial Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Nerve Transfer ◽  
Pinch Strength ◽  
Radial Nerve Palsy ◽  
Nerve Injuries ◽  
Tendon Transfers ◽  
Nerve Transfers ◽  
Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

Phrenic nerve palsy: a rare complication of indwelling subclavian vein catheter

2000 ◽  
Vol 14 (3) ◽  
pp. 203-204 ◽  
Author(s):  
S. Aggarwal ◽  
P. Hari ◽  
A. Bagga ◽  
S.N. Mehta
Keyword(s):  
Phrenic Nerve ◽  
Subclavian Vein ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Phrenic Nerve Palsy ◽  
Vein Catheter

scholarly journals Irritable bowel syndrome in midlife women: a narrative review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Pei-Lin Yang ◽  
Margaret M. Heitkemper ◽  
Kendra J. Kamp
Keyword(s):  
Irritable Bowel Syndrome ◽  
Management Strategies ◽  
Gastrointestinal Symptoms ◽  
Midlife Women ◽  
Pelvic Surgery ◽  
Poor Sleep ◽  
Hormonal Changes ◽  
Seek Health Care ◽  
Multiple Challenges ◽  
Irritable Bowel

AbstractMidlife women between the ages of 40 and 65 years have reported multiple challenges due to menopausal, developmental, and situational transitions from younger to older adulthood. During the midlife period, many women seek health care for gastrointestinal symptoms and irritable bowel syndrome (IBS). Multiple factors including stress, poor sleep, diet, and physical inactivity may contribute to IBS or gastrointestinal symptoms in midlife women. As such, a comprehensive assessment and treatment approach is needed for midlife women suffering gastrointestinal symptoms. This article reviews the main aspects of the menopausal transition, sex hormonal changes, abdominal and pelvic surgery, psychosocial distress, behavioral factors, and gut microbiome, as well as their relevance on IBS and gastrointestinal symptoms in midlife women. Also, management strategies for IBS in midlife women are discussed. To date, gastrointestinal symptoms during midlife years remain a critical area of women’s health. Additional research is needed to better understand the contributors to gastrointestinal symptoms in this group. Such efforts may provide a new window to refine or develop treatments of gastrointestinal symptoms for midlife women.

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