SOMATOSENSORY-EVOKED POTENTIAL MONITORING IN THE SURGICAL-TREATMENT OF ACUTE, DISPLACED ACETABULAR FRACTURES - RESULTS OF A PROSPECTIVE-STUDY

A prospective protocol was developed to prevent iatrogenic nerve injur y during the surgical treatment of acute, displaced acetabular fractur es in 103 patients. The protocol included an independent neurologic ev aluation and perioperative somatosensory evoked potential (SEP) monito ring (tibial division only). The incidence of posttraumatic nerve inju ry was 29% (30/103 patients). The incidence of postoperative nerve inj ury was 5% (5/ 103 patients): complete sciatic, 0; tibial division, 0; peroneal division, 5. Somatosensory evoked potential monitoring of th e tibial division is effective in preventing injury to this division. If perioperative SEP monitoring is used, independent stimulation of th e tibial and peroneal divisions is recommended. High-risk groups for p erioperative injury to the sciatic nerve include those patients with s ignificant posterior column or wall displacement or posttraumatic scia tic nerve injury.