Acute Lumbosacral Plexopathy Following Femoral Fracture: An Unusual Association
Abstract
Background: Post traumatic lumbosacral plexopathy (LSP) is a well-known condition following pelvic fracture or abdominal trauma and surgery. A rare condition of LSP has been reported in the literature following femoral shaft fractures.
Case Report: Two cases of LSP after bilateral femoral shaft fracture presented to our center. In both cases, the mechanism of injury was a high energy trauma without any signs or symptoms of pelvic or spinal injury. Electrodiagnostic studies confirmed acute plexopathy and spontaneous recovery occurred in both.
Conclusion: LSP can be seen in association with fractures or traumas far from anatomical location of the plexus. Multidisciplinary approach and complete accurate examination are mandatory for diagnosis management of the condition.
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10. Moldaver J. Tourniquet paralysis syndrome. AMA Arch Surg. 1954;68(2):136-44. doi: 10.1001/archsurg.1954.01260050138002. [PubMed: 13123650].
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12. Seror P, Maisonobe T, Viala K, Bouche P. Idiopathic lumbosacral plexopathy. Presse Med. 2005;34(12):856-8. doi: 10.1016/s0755-4982(05)84063-1. [PubMed: 16097208].
13. Dwyer T, Drexler M, Chan VW, Whelan DB, Brull R. Neurological complications related to elective orthopedic surgery: Part 2: Common hip and knee procedures. Reg Anesth Pain Med.
2015;40(5):443-54.doi:10.1097/AAP.0000000000000183.
[PubMed: 26192547].
2. Tonsgard JH, Kwak SM, Short MP, Dachman AH. CT imaging in adults with neurofibromatosis-1: frequent asymptomatic plexiform lesions. Neurology. 1998;50(6):1755-60. doi: 10.1212/wnl.50.6.1755. [PubMed: 9633723].
3. Dyck PJ, Thaisetthawatkul P. Lumbosacral plexopathy. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1343-58. doi: 10.1212/01.CON.0000455877.60932.d3. [PubMed: 25299286].
4. Frykholm GJ, Sintorn K, Montelius A, Jung B, Pahlman L, Glimelius B. Acute lumbosacral plexopathy during and after
preoperative radiotherapy of rectal adenocarcinoma. Radiother Oncol. 1996;38(2):121-30. doi: 10.1016/0167-8140(95)01665-1. [PubMed: 8966224].
5. Alsever JD. Lumbosacral plexopathy after gynecologic surgery: Case report and review of the literature. Am J Obstet Gynecol.
1996;174(6):1769-77.doi:10.1016/s0002-9378(96)70209-0.
[PubMed: 8678139].
6. Kutsy RL, Robinson LR, Routt ML Jr. Lumbosacral plexopathy in pelvic trauma. Muscle Nerve. 2000;23(11):1757-60. doi: 10.1002/1097-4598(200011)23:11<1757::aid-mus13>3.0.co;2-m.
[PubMed: 11054756].
7. Sugimoto Y, Ito Y, Tomioka M, Tanaka M, Hasegawa Y, Nakago K, et al. Risk factors for lumbosacral plexus palsy related to pelvic fracture. Spine (Phila Pa 1976). 2010;35(9):963-6. doi: 10.1097/BRS.0b013e3181bb85d0. [PubMed: 20150832].
8. Stoehr M. Traumatic and postoperative lesions of the lumbosacral plexus. Arch Neurol. 1978;35(11):757-60. doi: 10.1001/archneur.1978.00500350061013. [PubMed: 718476].
9. Ishii K, Tamaoka A, Shoji S. MRI of idiopathic lumbosacral
plexopathy. Neurology. 2004;63(2):E6. doi: 10.1212/01.wnl.0000134879.61017.dc. [PubMed: 15277659].
10. Moldaver J. Tourniquet paralysis syndrome. AMA Arch Surg. 1954;68(2):136-44. doi: 10.1001/archsurg.1954.01260050138002. [PubMed: 13123650].
11. Flierl MA, Stahel PF, Hak DJ, Morgan SJ, Smith WR. Traction table-related complications in orthopaedic surgery. J Am Acad Orthop Surg. 2010;18(11):668-75. doi: 10.5435/00124635-201011000-00004. [PubMed: 21041801].
12. Seror P, Maisonobe T, Viala K, Bouche P. Idiopathic lumbosacral plexopathy. Presse Med. 2005;34(12):856-8. doi: 10.1016/s0755-4982(05)84063-1. [PubMed: 16097208].
13. Dwyer T, Drexler M, Chan VW, Whelan DB, Brull R. Neurological complications related to elective orthopedic surgery: Part 2: Common hip and knee procedures. Reg Anesth Pain Med.
2015;40(5):443-54.doi:10.1097/AAP.0000000000000183.
[PubMed: 26192547].
| Files | ||
| Issue | Vol 7, No 1 (2021) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v7i1.5966 | |
| Keywords | ||
| Femoral Fractures; Lower Extremity; Lumbosacral Plexus | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Zeinali M, Haghi Ashtiani B, Nabian MH, Rabie H. Acute Lumbosacral Plexopathy Following Femoral Fracture: An Unusual Association. J Orthop Spine Trauma. 2021;7(1):34-6.
