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Femoral neuropathy secondary to the use of a self-retaining retractor

1995; Lippincott Williams & Wilkins; Volume: 38; Issue: 10 Linguagem: Inglês

10.1007/bf02133990

1530-0358

Robert C. Brasch, Anthony J. Bufo, Paul F. Kreienberg, Garner P. Johnson,

Hip and Femur Fractures

PURPOSE: Three recent cases of femoral neuropathy at our institution following colorectal surgery have been ascribed to the use of the self-retaining BookwalterTM retractor. The pathophysiology of neural injury includes compression, stretch, transection, ligation, iliopsoas hematoma, ischemia, and cement encapsulation. The Alm of this study is to provide a comprehensive review of femoral nerve anatomy and mechanism of retractor injury. METHODS: The relationship of the femoral nerve to the lateral blade of the BookwaiterTM retractor was evaluated during colorectal surgery and in cadaveric dissections. RESULTS: The lateral blade of the self-retaining retractor was observed to either compress or impinge the intrapelvic portion of the femoral nerve. CONCLUSION: The incidence of postoperative femoral neuropathy is likely underestimated because a majority of cases are self-limited. This debilitating iatrogenic injury can be prevented with a thorough understanding of femoral nerve anatomy and careful placement of self-retaining retractor blades.