Annals of plastic surgery
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Annals of plastic surgery · Dec 2005
Postarthroplasty "palsy" and systemic neuropathy: a peripheral-nerve management algorithm.
Postarthroplasty palsy, occurrence of dysfunction of the sciatic or peroneal nerve after total joint replacement of the hip or knee, is a complication that remains poorly understood. Characteristics of a series of 24 patients with postarthroplasty palsy are reviewed, with the finding that, overall, 58.4% of the patients had an underlying peripheral neuropathy. ⋯ This clinical problem is addressed from the perspective of peripheral nerve surgery, with an algorithm suggested for its management. The algorithm suggests that if a peroneal palsy is still present at 3 months after an arthroplasty and neurosensory testing fails to demonstrate a sensory reinnervation pattern in the territories of the deep or superficial peroneal nerve, then surgical neurolysis of the common peroneal nerve is indicated.