Transcript of "orthopedics. sciatic n. injury.(baxtyar rasul)"
Anatomy Supplies: Hamstrings (posterior of thigh) Above knee divided into : (1)Common peroneal: Superficial peroneal : The two peronei Skin of lateral of leg and dorsum of foot except 1st cleft Deep peroneal: Muscles of anterior compartment of the leg Skin of 1st cleft (2)Tibial nerve : muscles of the calf Skin of the sole
Causes of injury of the main trunk Gunshot Operative accidents Trauma following hip dislocation or fractures of the acetabulum
Symptoms and signs Paralysis of (1) Hamstrings (2) All muscles below the knee Foot drop Absent sensation in most of the leg Trophic ulcers ±
Treatment Urgent reduction of hip dislocation Proper treatment of fractures Open wounds: Repair While recovery is awaited a drop-foot splint is fitted
<ul><li>Prognosis </li></ul><ul><li>Poor </li></ul><ul><li>At best it will be delayed and incomplete </li></ul><ul><li>If there is no recovery whatever, amputation may be preferable to a </li></ul><ul><li>flail, deformed, insensitive limb </li></ul>
Clinical features Intermittent tingling OR pain OR numbness These symptoms are related to specific postures which compromise the nerve. e.g. CTS : flexion or hyperextension of the wrist Ulnar neuropathy : flexion of the elbow for a long time(driving, using telephone) Areas of altered sensation Motor weakness Muscle wasting
Treatment Avoiding compromising postures Light splints Local steroid injection If all above failed : Surgical decompression
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