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Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report
Traumatic or iatrogenic sciatic nerve injury, but not superior gluteal nerve injury, is a well described complication after acetabular fractures. Most often, sciatic nerve injuries occur in fractures involving the posterior column/wall with a hip dislocation and posterior fracture displacement resul...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709232/ https://www.ncbi.nlm.nih.gov/pubmed/36465139 http://dx.doi.org/10.1016/j.tcr.2022.100741 |
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author | Hinz, Nico Fuchs, Stefan Frosch, Karl-Heinz Hartel, Maximilian J. |
author_facet | Hinz, Nico Fuchs, Stefan Frosch, Karl-Heinz Hartel, Maximilian J. |
author_sort | Hinz, Nico |
collection | PubMed |
description | Traumatic or iatrogenic sciatic nerve injury, but not superior gluteal nerve injury, is a well described complication after acetabular fractures. Most often, sciatic nerve injuries occur in fractures involving the posterior column/wall with a hip dislocation and posterior fracture displacement resulting in narrowing of the greater sciatic foramen and injuring the sciatic nerve passing through. In this case report, a case of abductor mechanism deficiency with positive Trendelenburg's sign after an acetabular fracture of the posterior column with hip dislocation is presented. Postoperative clinical and MRI examination revealed a neurogenic atrophy of gluteus medius and minimus muscles suggesting a superior gluteal nerve injury due to initial subtotal incarceration of the greater sciatic foramen by a displaced posterior fracture fragment. An additional mild sciatic nerve injury resolved in the early postoperative course, while intensive physiotherapy improved the patient's complaints and muscular atrophy caused by the superior gluteal nerve injury within 12 months. This case report intends to raise awareness for rare neurological complications after acetabular fractures for their early detection. |
format | Online Article Text |
id | pubmed-9709232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-97092322022-12-01 Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report Hinz, Nico Fuchs, Stefan Frosch, Karl-Heinz Hartel, Maximilian J. Trauma Case Rep Case Report Traumatic or iatrogenic sciatic nerve injury, but not superior gluteal nerve injury, is a well described complication after acetabular fractures. Most often, sciatic nerve injuries occur in fractures involving the posterior column/wall with a hip dislocation and posterior fracture displacement resulting in narrowing of the greater sciatic foramen and injuring the sciatic nerve passing through. In this case report, a case of abductor mechanism deficiency with positive Trendelenburg's sign after an acetabular fracture of the posterior column with hip dislocation is presented. Postoperative clinical and MRI examination revealed a neurogenic atrophy of gluteus medius and minimus muscles suggesting a superior gluteal nerve injury due to initial subtotal incarceration of the greater sciatic foramen by a displaced posterior fracture fragment. An additional mild sciatic nerve injury resolved in the early postoperative course, while intensive physiotherapy improved the patient's complaints and muscular atrophy caused by the superior gluteal nerve injury within 12 months. This case report intends to raise awareness for rare neurological complications after acetabular fractures for their early detection. Elsevier 2022-11-25 /pmc/articles/PMC9709232/ /pubmed/36465139 http://dx.doi.org/10.1016/j.tcr.2022.100741 Text en © 2022 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Hinz, Nico Fuchs, Stefan Frosch, Karl-Heinz Hartel, Maximilian J. Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title | Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title_full | Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title_fullStr | Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title_full_unstemmed | Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title_short | Neurogenic gluteus medius and minimus muscle atrophy with Trendelenburg's sign after a displaced acetabular fracture of the posterior column – A case report |
title_sort | neurogenic gluteus medius and minimus muscle atrophy with trendelenburg's sign after a displaced acetabular fracture of the posterior column – a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709232/ https://www.ncbi.nlm.nih.gov/pubmed/36465139 http://dx.doi.org/10.1016/j.tcr.2022.100741 |
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