Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 1994
Innervation of the human knee joint and implications for surgery.
The anatomy of the articular and cutaneous nerves about the knee was investigated through 45 dissections of human anatomic specimens. The variability and location of these nerves are described and related to soft tissue and bony landmarks. Three constant nerves exist at the medial aspect of the knee, two of which have cutaneous territories that extend across the midline. ⋯ Two lateral articular nerves were found consistently in relation to reliable landmarks. The innervation to the lateral knee skin is variable from either the lateral femoral cutaneous nerve or branches of the femoral nerve. This anatomy provides a basis for nerve blocks and selective denervation in the treatment of knee pain.
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Clin. Orthop. Relat. Res. · Apr 1994
Case ReportsCompartment syndrome in the well leg resulting from fracture-table positioning.
A variety of patient positioning options exist on modern fracture tables for use during intramedullary nailing procedures. With the advent of interlocking and reconstruction nailing, some of these procedures can be complicated and prolonged. The use of the hemilithotomy position for prolonged intramedullary nailing procedures can result in the development of a compartment syndrome in the uninjured leg, no matter what type of suspension device is used for that leg. ⋯ Two patients at this institution have had such a condition in the past two years, and the authors have revised their positioning procedures. Review of the surgical literature shows that this complication has been seen in urologic, gynecologic, and general surgical patients, but has not been widely reported in the orthopaedic population. Recommendations for avoiding this problem include the use of other positions or distraction devices when performing intramedullary nailings, or, when the hemilithotomy position cannot be avoided, early intraoperative repositioning of the leg when possible.