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Titolo:
Intraneural sciatic nerve pressures relative to the position of the hip and knee: A human cadaveric study
Autore:
Borrelli, J; Kantor, J; Ungacta, F; Ricci, W;
Indirizzi:
Washington Univ, Sch Med, Dept Orthopaed Surg, St Louis, MO USA WashingtonUniv St Louis MO USA d, Dept Orthopaed Surg, St Louis, MO USA
Titolo Testata:
JOURNAL OF ORTHOPAEDIC TRAUMA
fascicolo: 4, volume: 14, anno: 2000,
pagine: 255 - 258
SICI:
0890-5339(200005)14:4<255:ISNPRT>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACETABULAR FRACTURES; COMPRESSION;
Keywords:
sciatic nerve injury; tissue fluid pressures; critical threshold;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Borrelli, J 1 Barnes Jewish Hosp Plaza,Suite 11300, St Louis, MO 63110 USA 1 Barnes Jewish Hosp Plaza,Suite 11300 St Louis MO USA 63110
Citazione:
J. Borrelli et al., "Intraneural sciatic nerve pressures relative to the position of the hip and knee: A human cadaveric study", J ORTHOP TR, 14(4), 2000, pp. 255-258

Abstract

Objectives: To determine the effects of ipsilateral hip and knee position on intraneural sciatic nerve pressures. Design: Intraneural sciatic nerve pressures measured in intact, fresh cadaveric specimens relative to ipsilateral hip and knee positions. Location: Medical school anatomy laboratory. Subjects: Randomly acquired adult cadavers. Intervention: Pressure transducer placed within the sciatic nerve distal to the femoral attachment of the gluteus maximus. Intraneural pressures measured with the hip placed in 0, 45, and 90 degrees of flexion while the kneewas positioned in 90, 45, and 0 degrees of flexion. Main Outcome Measurements: Tissue fluid pressures within the sciatic nerverelative to the position of the ipsilateral hip and knee. Tissue fluid pressure within the sciatic nerve exceeded previously defined critical thresholds for alteration of neural microcirculation and function. Although increased intraneural pressures were realized as the hip was positioned in greater flexion and the knee was extended, clinically relevant pressures were realized only when the hip was flexed to 90 degrees and the knee was fully extended. Pressures with the limbs in these positions were fifty-five millimeters of mercury (range 38 to 74 millimeters of mercury). Results: With the hip held flexed to 90 degrees, statistically significantly increased intraneural pressures were measured as the knee was extended from 90 to 45 degrees of flexion (p = 0.048) and again from 45 to 0 degrees of flexion (p less than or equal to 0.01). With the knee positioned in 45 degrees of flexion, statistically significantly increased intraneural pressures were measured as the hip was flexed from 45 to 90 degrees (p less than or equal to 0.0062). When the knee was held fully extended, statistically significantly increased intraneural pressures were measured as the hip was flexed from 0 to 45 degrees of flexion (p = 0.0006) and again when the hip was brought from 45 to 90 degrees of flexion (p less than or equal to 0.01). Conclusions: Intraneural sciatic nerve pressures are influenced by the position of the ipsilateral hip and knee. The magnitude of the pressure elevation appears to be related to the excursion of the nerve as the linear distance between the greater sciatic notch and the distal aspect of the leg increases. Intraneural tissue fluid pressures measured within a localized section of the sciatic nerve appeared to exceed published critical thresholds for alterations of blood flow and neural function only when the hip was flexed to 90 degrees and the knee was fully extended.

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Documento generato il 30/11/20 alle ore 02:38:18