Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
Neuropathy in surgical-related locations has received concerns after total hip arthroplasty (THA), while the contralateral intercostal nerve (ICN) injury has not been reported. A 25-year-old female patient with a body mass index (BMI) of 17.9 kg/m2 visited the orthopedic outpatient clinic with compl...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2023-06-01
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| Series: | Open Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/med-2023-0731 |
| _version_ | 1797806221826195456 |
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| author | Wang Zhengming Zhang Jingjing Wang Rui Chen Quanquan Tong Peijian Zhan Hongsheng Lv Shuaijie |
| author_facet | Wang Zhengming Zhang Jingjing Wang Rui Chen Quanquan Tong Peijian Zhan Hongsheng Lv Shuaijie |
| author_sort | Wang Zhengming |
| collection | DOAJ |
| description | Neuropathy in surgical-related locations has received concerns after total hip arthroplasty (THA), while the contralateral intercostal nerve (ICN) injury has not been reported. A 25-year-old female patient with a body mass index (BMI) of 17.9 kg/m2 visited the orthopedic outpatient clinic with complaints of progressive left hip pain for 20 days. She was diagnosed with left end-stage hip osteoarthritis and developmental dysplasia of the bilateral hips after radiographs and a detailed history-taking. After painstaking consideration, a cementless THA with the standard posterolateral approach was performed under general anesthesia. The procedure was difficult but successful. Unexpectedly, the numbness and slight tingling in the skin of the right breast, lateral chest wall, and axilla cropped up on the first postoperative day. Following the clinical features and the conclusion of the multidisciplinary discussion, we assume that ICN neuropathy is the diagnosis in this case due to compression of the lateral decubitus position during the operation. Her symptoms completely disappeared after using mecobalamin injection (0.5 mg, intramuscular injection, every other day) for 11 days. The Harris left hip score improved from 39 to 94, and the visual analogue scale from 7 was reduced to 2 on the day of discharge. There were no other complications within the first year after the operation. For THA, we should pay attention to some unexpected complications by virtue of the special position, especially in thin and low-BMI people, which suggested that further comprehensive perioperative nursing measures and the beneficial surgical position and anesthesia type were called for. |
| first_indexed | 2024-03-13T06:04:00Z |
| format | Article |
| id | doaj.art-35f0adccbb9e47d1861941d3e21b8385 |
| institution | Directory Open Access Journal |
| issn | 2391-5463 |
| language | English |
| last_indexed | 2024-03-13T06:04:00Z |
| publishDate | 2023-06-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Open Medicine |
| spelling | doaj.art-35f0adccbb9e47d1861941d3e21b83852023-06-12T06:31:12ZengDe GruyterOpen Medicine2391-54632023-06-0118115081910.1515/med-2023-0731Does total hip arthroplasty result in intercostal nerve injury? A case report and literature reviewWang Zhengming0Zhang Jingjing1Wang Rui2Chen Quanquan3Tong Peijian4Zhan Hongsheng5Lv Shuaijie6Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Zhejiang, 310006, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Zhejiang, 310006, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Zhejiang, 310006, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Zhejiang, 310006, ChinaShuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, ChinaNeuropathy in surgical-related locations has received concerns after total hip arthroplasty (THA), while the contralateral intercostal nerve (ICN) injury has not been reported. A 25-year-old female patient with a body mass index (BMI) of 17.9 kg/m2 visited the orthopedic outpatient clinic with complaints of progressive left hip pain for 20 days. She was diagnosed with left end-stage hip osteoarthritis and developmental dysplasia of the bilateral hips after radiographs and a detailed history-taking. After painstaking consideration, a cementless THA with the standard posterolateral approach was performed under general anesthesia. The procedure was difficult but successful. Unexpectedly, the numbness and slight tingling in the skin of the right breast, lateral chest wall, and axilla cropped up on the first postoperative day. Following the clinical features and the conclusion of the multidisciplinary discussion, we assume that ICN neuropathy is the diagnosis in this case due to compression of the lateral decubitus position during the operation. Her symptoms completely disappeared after using mecobalamin injection (0.5 mg, intramuscular injection, every other day) for 11 days. The Harris left hip score improved from 39 to 94, and the visual analogue scale from 7 was reduced to 2 on the day of discharge. There were no other complications within the first year after the operation. For THA, we should pay attention to some unexpected complications by virtue of the special position, especially in thin and low-BMI people, which suggested that further comprehensive perioperative nursing measures and the beneficial surgical position and anesthesia type were called for.https://doi.org/10.1515/med-2023-0731neuropathyintercostal nervepositiontotal hip arthroplasty |
| spellingShingle | Wang Zhengming Zhang Jingjing Wang Rui Chen Quanquan Tong Peijian Zhan Hongsheng Lv Shuaijie Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review Open Medicine neuropathy intercostal nerve position total hip arthroplasty |
| title | Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review |
| title_full | Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review |
| title_fullStr | Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review |
| title_full_unstemmed | Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review |
| title_short | Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review |
| title_sort | does total hip arthroplasty result in intercostal nerve injury a case report and literature review |
| topic | neuropathy intercostal nerve position total hip arthroplasty |
| url | https://doi.org/10.1515/med-2023-0731 |
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