Femoral nerve palsy after pelvic fracture treated with INFIX: a case series.

Abstract

The treatment of some pelvic injuries has evolved recently to include the use of a subcutaneous anterior pelvic fixator (INFIX). We present 8 cases of femoral nerve palsy in 6 patients after application of an INFIX to highlight this potentially devastating complication to pelvic surgeons using this technique and discuss how it might be avoided in the future. Retrospective chart review. Case series. Five level 1 and 2 trauma centers, tertiary referral hospitals. Six patients with anterior pelvic ring injury treated with an INFIX who experienced 8 femoral nerve palsies (2 bilateral). Removal of internal fixator, treatment for femoral nerve palsy. Clinical and electromyographic evaluation of patients. All 6 patients with a total of 8 femoral nerve palsies had their INFIX removed. Variable resolution of the nerve injuries was observed. Application of an INFIX for the treatment of pelvic ring injury carries a potentially devastating risk to the femoral nerve(s). Despite early implant removal after detection of nerve injury, some patients had residual quadriceps weakness, disturbance of the thigh's skin sensation, and/or gait disturbance attributable to femoral nerve palsy at the time of early final follow-up. Therapeutic level IV. See Instructions for Authors for a complete description of levels of evidence.