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Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis

The obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on r...

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Autores principales: Shima, Daichi, Kinoshita, Tokio, Umemoto, Yasunori, Yasuoka, Yoshinori, Hashizaki, Takamasa, Asaeda, Makoto, Nishimura, Yukihide, Yahata, Tamaki, Shimoe, Takashi, Tajima, Fumihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9902874/
https://www.ncbi.nlm.nih.gov/pubmed/36761343
http://dx.doi.org/10.3389/fneur.2023.1062018
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author Shima, Daichi
Kinoshita, Tokio
Umemoto, Yasunori
Yasuoka, Yoshinori
Hashizaki, Takamasa
Asaeda, Makoto
Nishimura, Yukihide
Yahata, Tamaki
Shimoe, Takashi
Tajima, Fumihiro
author_facet Shima, Daichi
Kinoshita, Tokio
Umemoto, Yasunori
Yasuoka, Yoshinori
Hashizaki, Takamasa
Asaeda, Makoto
Nishimura, Yukihide
Yahata, Tamaki
Shimoe, Takashi
Tajima, Fumihiro
author_sort Shima, Daichi
collection PubMed
description The obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on rehabilitation after neurotmesis. Furthermore, there are no reports on the status of activities of daily living (ADL) and details of physical therapy in patients with paralysis of the adductor muscle group. In this study, we reported on a patient with adductor paralysis due to obturator neurotmesis, including the clinical symptoms, characteristics of ADL impairment, and effective movement instruction. The patient is a woman in her 40's who underwent laparoscopic total hysterectomy, bilateral adnexectomy, and pelvic lymph node dissection for uterine cancer (grade-2 endometrial carcinoma). During pelvic lymph node dissection, she developed an obturator nerve injury. She underwent nerve grafting during the same surgery by the microsurgeon. Donor nerve was the ipsilateral sural nerve with a 3-cm graft length. Due to obturator nerve palsy, postoperative manual muscle test results were as follows: adductor magnus muscle, 1; pectineus muscle, 1; adductor longs muscle, 0; adductor brevis muscle, 0; and gracilis muscle, 0. On postoperative day 6, the patient could independently perform ADL; however, she was at risk of falling toward the affected side when putting on and taking off her shoes while standing on the affected leg. The patient was discharged on postoperative day 8. Through this case, we clarified the ADL impairment of a patient with adductor muscle palsy following obturator neurotmesis, and motion instruction was effective as physical therapy for this disability. This case suggests that movement instruction is important for acute rehabilitation therapy for patients with hip adductor muscle group with obturator neurotmesis.
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spelling pubmed-99028742023-02-08 Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis Shima, Daichi Kinoshita, Tokio Umemoto, Yasunori Yasuoka, Yoshinori Hashizaki, Takamasa Asaeda, Makoto Nishimura, Yukihide Yahata, Tamaki Shimoe, Takashi Tajima, Fumihiro Front Neurol Neurology The obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on rehabilitation after neurotmesis. Furthermore, there are no reports on the status of activities of daily living (ADL) and details of physical therapy in patients with paralysis of the adductor muscle group. In this study, we reported on a patient with adductor paralysis due to obturator neurotmesis, including the clinical symptoms, characteristics of ADL impairment, and effective movement instruction. The patient is a woman in her 40's who underwent laparoscopic total hysterectomy, bilateral adnexectomy, and pelvic lymph node dissection for uterine cancer (grade-2 endometrial carcinoma). During pelvic lymph node dissection, she developed an obturator nerve injury. She underwent nerve grafting during the same surgery by the microsurgeon. Donor nerve was the ipsilateral sural nerve with a 3-cm graft length. Due to obturator nerve palsy, postoperative manual muscle test results were as follows: adductor magnus muscle, 1; pectineus muscle, 1; adductor longs muscle, 0; adductor brevis muscle, 0; and gracilis muscle, 0. On postoperative day 6, the patient could independently perform ADL; however, she was at risk of falling toward the affected side when putting on and taking off her shoes while standing on the affected leg. The patient was discharged on postoperative day 8. Through this case, we clarified the ADL impairment of a patient with adductor muscle palsy following obturator neurotmesis, and motion instruction was effective as physical therapy for this disability. This case suggests that movement instruction is important for acute rehabilitation therapy for patients with hip adductor muscle group with obturator neurotmesis. Frontiers Media S.A. 2023-01-24 /pmc/articles/PMC9902874/ /pubmed/36761343 http://dx.doi.org/10.3389/fneur.2023.1062018 Text en Copyright © 2023 Shima, Kinoshita, Umemoto, Yasuoka, Hashizaki, Asaeda, Nishimura, Yahata, Shimoe and Tajima. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Shima, Daichi
Kinoshita, Tokio
Umemoto, Yasunori
Yasuoka, Yoshinori
Hashizaki, Takamasa
Asaeda, Makoto
Nishimura, Yukihide
Yahata, Tamaki
Shimoe, Takashi
Tajima, Fumihiro
Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title_full Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title_fullStr Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title_full_unstemmed Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title_short Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
title_sort case report: physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9902874/
https://www.ncbi.nlm.nih.gov/pubmed/36761343
http://dx.doi.org/10.3389/fneur.2023.1062018
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