• Daniel Hesse, Utku Kandmir, Brian Solberg, Alex Stroh, Greg Osgood, Stephen A Sems, and Cory A Collinge.
• *Department of Orthopaedic Surgery, Queens University, Kingston, Ontario, Canada; †Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA; ‡Los Angeles Orthopaedic Specialists, Los Angeles, CA; §Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD; ‖Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and ¶Harris Methodist Fort Worth Hospital, Fort Worth, TX.
• J Orthop Trauma. 2015 Mar 1;29(3):138-43.

ObjectiveThe treatment of some pelvic injuries has evolved recently to include the use of a subcutaneous anterior pelvic fixator (INFIX). We present 8 cases of femoral nerve palsy in 6 patients after application of an INFIX to highlight this potentially devastating complication to pelvic surgeons using this technique and discuss how it might be avoided in the future.DesignRetrospective chart review. Case series.SettingFive level 1 and 2 trauma centers, tertiary referral hospitals.Patients/ParticipantsSix patients with anterior pelvic ring injury treated with an INFIX who experienced 8 femoral nerve palsies (2 bilateral).InterventionRemoval of internal fixator, treatment for femoral nerve palsy.Main Outcome MeasurementsClinical and electromyographic evaluation of patients.ResultsAll 6 patients with a total of 8 femoral nerve palsies had their INFIX removed. Variable resolution of the nerve injuries was observed.ConclusionsApplication of an INFIX for the treatment of pelvic ring injury carries a potentially devastating risk to the femoral nerve(s). Despite early implant removal after detection of nerve injury, some patients had residual quadriceps weakness, disturbance of the thigh's skin sensation, and/or gait disturbance attributable to femoral nerve palsy at the time of early final follow-up.Level Of EvidenceTherapeutic level IV. See Instructions for Authors for a complete description of levels of evidence.

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