Pudendal Nerve Palsy Following Static Intramedullary Nailing of the Femur (original) (raw)

Abstract

Objective: To determine the incidence of pudendal nerve palsies following static interlocking nailing of the femur, and to relate its development to age, body mass index, amount of pre-operative shortening, timing of surgery, level and type of fracture, duration of intra-operative traction, and use of muscle relaxants during surgery. Method: Twenty-nine consecutive patients who were treated with intramedullary nailing for femoral shaft fractures were prospectively studied. The age, body mass index, level and type of fracture, pre-operative traction, timing of surgery, preoperative shortening, duration of intra-operative traction, and use of muscle relaxants were recorded. Post-operatively, each patient was examined for altered sensation in the perineum. Men were asked about erectile function. Results: Eight patients (27.6%) developed palsies. All patients regained normal sensation and function. No significant differences were found between pudendal nerve injury and age, body mass index, pre-operative shortening, timing of surgery, level of fracture, muscle relaxant use, and duration of intra-operative traction. Significantly more palsies were present in patients with comminuted fractures. Conclusion: Intramedullary nailing of the femur is associated with pudendal nerve palsy. There is a significant correlation between pudendal nerve palsy and comminuted fractures.

Figures (1)

CORRESPONDENCE TO Table 1: Guidelines for Minimizing the Risk of Pudendal Nerve Palsy Dr REC Rose, Division of Orthopaedics, Department of

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