• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.2
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• pp.92-95
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• 2012

Iliacus muscle tears are a rare injury seen after the high-energy trauma or as a result of low-energy injuries in patients with a bleeding diathesis as coagulopathy, receiving anticoagulation therapy and hemophiliac. Femoral nerve palsy due to compression from a hematoma by iliacus muscle rupture are rarely reported. Routine evaluation includes MRI to confirm and define the pathologic abnormality supplemented by EMG and nerve conduction studies to evaluate patterns and extent of femoral nerve injury. Hematologic evaluation for bleeding diathesis may preceded, if suspicion of coagulopathy is present. We report the case of a healthy 32-year-old male with iliacus rupture and concomitant femoral nerve palsy sustained by kicking motion during soccer game. After 6 months of observation with non-operative treatment regimen, satisfactory results were obtained, so we report it with a review of the literatures.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.192-200
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• 2018

Objective: The purpose of this clinical study is to report the case of a 79-year-old man with weakness of the right lower limb due to postzoster femoral nerve palsy. Methods: A patient was treated with Korean medicine, including herbal medication, acupuncture, electro-acupuncture, and bee-venom, during 17 days of hospitalization. We evaluated the improvements of symptoms using manual muscle testing (MMT) and measuring the change in walking distance. Results: After 17 days of Korean medicine treatment, there was improvement in the patient's symptoms. MMT improved from 3- to 5, and walking distance improved from 2 spaces to 120 spaces. Conclusions: This study suggested that Korean medical treatment might be effective in the patient's recovery from postzoster femoral nerve palsy.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

• Advances in pediatric surgery
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• v.20 no.1
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.