Postoperative femoral motor neuropathy: diagnosis and treatment without neurologic consultation or testing.

Title

Postoperative femoral motor neuropathy: diagnosis and treatment without neurologic consultation or testing.

Creator

Fanning James; Carol Tiffany; Miller Dawn; Flora Robert

Publisher

The Journal of reproductive medicine

Date

2007
2007-04

Description

OBJECTIVE: To review the diagnosis and treatment of postoperative femoral motor neuropathy without neurologic consultation or testing. STUDY DESIGN: A retrospective review of 6 consecutive patients with postoperative femoral motor neuropathy following gynecologic surgery. Diagnosis was made on clinical evaluation: history of falling during postoperative ambulation, quadriceps weakness, straight leg raise weakness, diminished knee jerk response, and no evidence of psoas hematoma or abscess. Neurologic consultation, electromyography, nerve conduction study and radiologic imaging, such as computed tomography, were not obtained. Instead, a physical therapy consultation was obtained for a knee orthotic and rehabilitation. RESULTS: Four postoperative femoral motor neuropathies developed following 3,014 cases of major gynecologic surgery (0.1%). Two additional cases were seen in consultation. The median age was 57 years. All patients fell while attempting ambulation on postoperative day 1. Recovery occurred at a median of 3 months (1-4). At a median follow-up of 4 years, no patient had developed additional neurologic sequelae. A history of prior postoperative femoral motor neuropathy was noted in 2 of 6 patients (33%). CONCLUSION: This was the first study of diagnosis and treatment of postoperative femoral motor neuropathy following gynecologic surgery without neurologic consultation or testing. Because of the significant expense of neurologic consultation and testing, patients with postoperative femoral motor neuropathy can have the condition diagnosed by the gynecologist and be referred directly to physical therapy without adversely affecting outcome. This also was the first study to elicit a prior history offemoral neuropathy in 33% of patients. Thus, a prior history may be a risk factor for recurrence.

Subject

Female; Humans; Middle Aged; Retrospective Studies; Treatment Outcome; Risk Factors; Gynecologic Surgical Procedures/*adverse effects; Recurrence; *Physical Therapy Modalities; *Postoperative Complications/diagnosis/therapy; Accidental Falls; Femoral Nerve/physiopathology; Femoral Neuropathy/*diagnosis/*therapy; Neural Conduction; Pelvic Neoplasms/surgery; Pelvis/surgery; Genital Neoplasms; Female/surgery

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

285–288

Issue

4

Volume

52

Citation

Fanning James; Carol Tiffany; Miller Dawn; Flora Robert, “Postoperative femoral motor neuropathy: diagnosis and treatment without neurologic consultation or testing.,” NEOMED Bibliography Database, accessed May 26, 2022, https://neomed.omeka.net/items/show/5394.

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