INTRAOPERATIVE EVOKED-POTENTIAL MONITORING IN ACETABULAR SURGERY

The effectiveness of intraoperative sciatic nerve monitoring was evalu ated for 88 consecutive patients undergoing open reduction and interna l fixation for acetabular fractures. Intervention outcomes and pre and postoperative electrophysiologic status were compared to postoperativ e functional findings. Only 2% of the patients demonstrated iatrogenic sciatic nerve palsies. Functional and evoked potential findings were in agreement for 89% of the patients with postoperative palsies, while 26% of the functionally normal patients showed abnormal evoked potent ials. Intervention occurred in 55 surgeries; 80% of interventions invo lved the peroneal nerve. Forty one of the 55 patients who had interven tions based on evoked potential results showed recovery of responses t o baseline. Of the 14 patients with incomplete intervention recovery, 11 showed impaired postoperative responses. Patients with preoperative evoked potential abnormalities did not show increased susceptibility to iatrogenic evoked potential changes,