FEMORAL NERVE LESION IN TOTAL HIP-REPLACEMENT - AN EXPERIMENTAL-STUDY

A total of 20 hip joints of 10 non-fixed corpses were examined within 48 h of death to measure the pressure below the inguinal ligament simu lating the surgical conditions during total hip arthroplasty. The purp ose of this study was to assess the influence of various leg positions and insertion techniques of retractors during the surgical procedure for total hip replacement in order to detect supposed causes for indir ect pressure injuries of the femoral nerve. The obtained results verif ied no increase of pressure in the inguinal canal which could explain an indirect injury of the femoral nerve. If the retractor is inserted correctly at the anterior acetabular rim, the pressure in the lacuna m usculorum can even be reduced, and furthermore, the femoral nerve is p rotected by the iliopsoas muscle. Femoral nerve lesions which have bee n published so far can only be explained by an incorrect use of instru ments or implants (e.g., screws, cement, acetabular cup) or an extreme postoperative leg length discrepancy.