J Am Acad Orthop Sur
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Meralgia paresthetica is a symptom complex that includes numbness, paresthesias, and pain in the anterolateral thigh, which may result from either an entrapment neuropathy or a neuroma of the lateral femoral cutaneous nerve (LFCN). The condition can be differentiated from other neurologic disorders by the typical exacerbating factors and the characteristic distribution of symptoms. The disease process can be either spontaneous or iatrogenic. ⋯ Prone positioning for spine surgery has also been implicated. Variations in the anatomy of the LFCN about the anterior superior iliac spine may place the nerve at higher risk for damage. Although nonoperative management usually results in satisfactory results, efforts should be made to avoid injury at the time of surgery.
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Pneumatic tourniquets maintain a relatively bloodless field during extremity surgery, minimize blood loss, aid identification of vital structures, and expedite the procedure. However, they may induce an ischemia-reperfusion injury with potentially harmful local and systemic consequences. Modern pneumatic tourniquets are designed with mechanisms to regulate and maintain pressure. ⋯ The complications of tourniquet use include postoperative swelling, delay of recovery of muscle power, compression neurapraxia, wound hematoma with the potential for infection, vascular injury, tissue necrosis, and compartment syndrome. Systemic complications can also occur. The incidence of complications can be minimized by use of wider tourniquets, careful preoperative patient evaluation, and adherence to accepted principles of tourniquet use.