The Journal of Bone and Joint Surgery, Vol 61, Issue 1 37-39, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Sciatic paralysis. A complication of bleeding following hip surgery
RE Fleming, CB Michelsen and FE Stinchfield
Of five patients in who sciatic paresis developed as the result of
hemorrhage and hematoma following hip surgery, four were receiving
prophylactic or therapeutic anticoagulants. The patient who was managed
expectantly still had disabling motor and sensory deficity at follow-up.
Three patients who had early operative decompression showed more complete
return of nerve function. The fifth patient died three weeks after onset
with the neuropathy still present. Severe low-back and buttock pain,
ecchymosis over these regions, marked swelling in the thigh, sciatic-nerve
tenderness, and a distal sciatic neural deficit in the ipsilateral lower
limb of a patient who has had hip surgery are evidence of hemorrhage in the
vicinity of the sciatic nerve. Early recognition and prompt surgical
decompression can prevent irreversible nerve damage.
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