• Title/Summary/Keyword: femoral nerve

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Iliacus Muscle Rupture with Associated Partial Femoral Nerve Palsy during Soccer Game - Case Report - (축구 경기 중 발생한 장골근 파열과 부분 대퇴 신경 마비 - 증례보고 -)

  • Jung, Sung-Hoon;Lee, Sang-Ho;Song, Kyeong-Seop;Park, Byeong-Mun;Ki, Chul Hyun
    • 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.

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Neurogenic pathways in remote ischemic preconditioning induced cardioprotection: Evidences and possible mechanisms

  • Aulakh, Amritpal Singh;Randhawa, Puneet Kaur;Singh, Nirmal;Jaggi, Amteshwar Singh
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.2
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    • pp.145-152
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    • 2017
  • Remote ischemic preconditioning (RIPC) is an intrinsic phenomenon whereby 3~4 consecutive ischemia-reperfusion cycles to a remote tissue (non-cardiac) increases the tolerance of the myocardium to sustained ischemia-reperfusion induced injury. Remote ischemic preconditioning induces the local release of chemical mediators which activate the sensory nerve endings to convey signals to the brain. The latter consequently stimulates the efferent nerve endings innervating the myocardium to induce cardioprotection. Indeed, RIPC-induced cardioprotective effects are reliant on the presence of intact neuronal pathways, which has been confirmed using nerve resection of nerves including femoral nerve, vagus nerve, and sciatic nerve. The involvement of neurogenic signaling has been further substantiated using various pharmacological modulators including hexamethonium and trimetaphan. The present review focuses on the potential involvement of neurogenic pathways in mediating remote ischemic preconditioning-induced cardioprotection.

Two Clinical Case Studies on Femoral Neuralgia with Nerve Entrapment (신경포착성 대퇴신경통 2례)

  • Koo, Ja-sung;Jang, Jae-won;Kim, Sang-min;Choi, Ji-hoon;Jang, Young-woo;Ki, Dong-jin
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.212-217
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    • 2016
  • Objective: This study reports on two patient cases with lower limb symptoms related to femoral nerve entrapment who were treated with traditional Korean medicinal treatments.Method: We used acupuncture and pharmacopuncture for several days and observed any changes in the patients’ symptoms.Results: After treatment, the numerical rating scale (NRS) of the first patient decreased from 7 to 1, while that of the second patient decreased from 10 to 1.Conclusion: The results of this study suggest that traditional Korean medicinal treatments may be effective in reducing symptoms related to femoral nerve entrapment.

Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica

  • Kim, Jeong-Eun;Lee, Sang-Gon;Kim, Eun-Ju;Min, Byung-Woo;Ban, Jong-Suk;Lee, Ji-Hyang
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.115-118
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    • 2011
  • Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

Radiofrequency Lesion Generation of the Articular Branches of the Obturator and Femoral Nerve for Hip Joint Pain -A case report- (고관절통을 위한 폐쇄신경 및 대퇴신경 관절지의 고주파열응고술 -증례보고-)

  • Shin, Keun Man;Nam, Sung Keun;Yang, Myo Jin;Hong, Seong Joon;Lim, So Young;Choi, Young Ryong
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.282-284
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    • 2006
  • Percutaneous radiofrequency thermocoagulation has been applied in patients with various forms of chronic pain, such as facet joint pain, cancer pain and trigeminal neuralgia. A major portion of the hip joint is innervated by the articular branches of the femoral and obturator nerves. Radiofrequency thermocoagulation of the articular branches of the obturator and femoral nerves can be a good alternative treatment for patients with hip joint pain, especially in those where surgery is not applicable. A patient suffering hip joint pain due to metastatic cancer underwent multiple radiofrequency lesioning of the femoral and obturator nerves at $80^{\circ}C$ for 120 seconds, using a Racz-Finch Kit. The patient experienced about a 50% reduction in the pain, without any numbness or other side effects.

The Effect of Bilateral Femoral Nerve Block Combined with Intravenous Patient-controlled Analgesia after a Bilateral Total Knee Replacement (양측 슬관절 전치환술 후 정맥 내 통증자가조절 시 대퇴신경차단의 병용이 미치는 영향)

  • Chung, Mee Young;Kim, Chang Jae
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.211-216
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    • 2008
  • Background: Postoperative pain after bilateral total knee replacement (TKR) is expected to be more severe than unilateral TKR. Intravenous patient-controlled analgesia (IV PCA) is less effective than other methods of pain management especially immediately after an operation even though it is an easily controlled method for managing pain. This study was designed to evaluate the effect of femoral nerve blocks combined with IV PCA after bilateral TKR for postoperative pain control. Methods: The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) were given bilateral femoral nerve blocks with 12 ml of 0.25% bupivacaine and epinephrine 1 : 400,000 before extubation followed by an IV PCA. Main outcome measures included numerical rating pain score, cumulative opioid consumption, hourly dose during each time interval, and side effects. Results: The pain score in group II was significantly lower than that in group I immediately after recovery of awareness and at 3, 6, 12 hours postoperatively. Cumulative opioid consumption was significantly decreased in group II during the first 48 hours postoperatively. The hourly dose in group II was also significantly lower than that in group I until 12 hours postoperatively. There was no difference in side effects between the groups. Conclusions: We concluded that bilateral femoral nerve blocks improve analgesia and decrease morphine use during IV PCA after bilateral TKR.

Lateral Femoral Cutaneous Nerve: Variety in Conduction (Seror's Method) According to Body Mass Index and Age (가쪽넙다리피부신경전도검사의 체질량지수와 나이에 따른 다양성)

  • Kim, Hyun Young;Han, Yang Sook;Koh, Seong-Ho;Kim, Juhan;Kim, Seung Hyun
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.152-157
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    • 2006
  • Background: Meralgia paresthesia (MP) is characterized by sensory impairment in the anterolateral aspect of the thigh and usually caused by a lateral femoral cutaneous nerve (LFCN) lesion. It is well known that several physiologic factors including age, obesity, and sex can affect nerve conduction. This study aimed to determine whether body mass index (BMI) and age can influence on the conduction velocity and action potential amplitude of the LFCN. Methods: Fifty six individuals without any previous neuromuscular disease participated in this study. LFCN was studied orthodromically, distally from the anterior superior iliac spine. The values, such as sensory nerve action potential (SNAP) amplitude and sensory nerve conduction velocity (NCV) were obtained. SNAP of the LFCN were formed on both sides in forty three individuals. Results: No difference of demographic factors was observed between two groups divided according to the presence of SNAP formation. BMI had a significant relationship with SNAP amplitude and NCV of the LFCN. Moreover, Multiple regression analyses of nerve conduction values showed the significant correlation of body mass index and age with nerve conduction velocity. Conclusions: We may suggest that nerve conduction of the LFCN can be affected by age and BMI. Further study to obtain normal nerve conduction data and compare these data with those of meralgia paresthetica patients should be continued.

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A Case of Meralgia Paresthetica caused by A Huge Renal Cyst (거대 콩팥낭종에 의한 넙다리감각이상증(meralgia paresthetica) 1예)

  • Kim, Tae-Yong;Kim, Jae-Hyuk;Kim, Su-Hyun;Lim, Eun-Kwang;Lee, Yeong-Bae;Shin, Dong-Jin
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.33-35
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    • 2007
  • Meralgia paresthetica (MP) is a benign entrapment neuropathy which is characterized by sensory impairment and paresthesia in the cutaneous distribution of the lateral femoral cutaneous nerve. A 79-year-old woman presented with intermittent right inguinal burning sensation. The sensory nerve conduction study (NCS) showed decreased right side sensory nerve action potential (SNAP) on lateral femoral cutaneous nerve compared to the contralateral one. Abdomino-pelvic CT showed bilateral huge renal cysts (The size of largest one on right side: about $6.2{\times}5.0cm$). We report a case of MP caused by a huge abdominal renal cyst, which should be considered when conventional examination reveals no responsible etiology.

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Ultrasound-Guided Femorosciatic Nerve Block (초음파 유도 대퇴좌골 신경 차단술)

  • Kang, Chan;Kim, Young-Mo;Hwang, Deuk-Soo;Kim, Joung-Hun;Park, Jun-Young;Lee, Woo-Yong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.74-78
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    • 2010
  • Since the extent of use of musculoskeletal ultrasound in orthopaedic surgery is expanding, popliteal block(sciatic nerve block) and femoral nerve block(saphenous nerve block) are easily and safely performed without complications such as nerve injury or incomplete block. Also, due to the expanding use of ultrasound, orthopaedic surgery of not only foot but also ankle and lower leg could be done without general anesthesia or spinal anesthesia. We describe a detailed technique for ultrasound-guided femorosciatic nerve block based on the experience over 120 cases.

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Ultrasound-Guided Pain Interventions - A Review of Techniques for Peripheral Nerves

  • Soneji, Neilesh;Peng, Philip Wenn Hsin
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.111-124
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    • 2013
  • Ultrasound has emerged to become a commonly used modality in the performance of chronic pain interventions. It allows direct visualization of tissue structure while allowing real time guidance of needle placement and medication administration. Ultrasound is a relatively affordable imaging tool and does not subject the practitioner or patient to radiation exposure. This review focuses on the anatomy and sonoanatomy of peripheral non-axial structures commonly involved in chronic pain conditions including the stellate ganglion, suprascapular, ilioinguinal, iliohypogastric, genitofemoral and lateral femoral cutaneous nerves. Additionally, the review discusses ultrasound guided intervention techniques applicable to these structures.