title: Fibular nerve palsy after hip replacement: Not only surgeon responsibility. Hereditary neuropathy with liability to pressure palsies (HNPP) a rare cause of nerve liability.
abstract: Mononeuropathy after surgery may occur and hereditary neuropathy with liability to pressure palsies is a possible pathological condition related to paresis after hip surgery. We present a case of 66-year-old man presenting severe weakness at inferior limb muscles after hip prosthesis revision. Clinic and electrophysiology showed severe right fibular nerve damage and ultrasound found a marked enlargement of the same nerve, associated with focal enlargements in other nerves. A diagnosis of hereditary neuropathy with liability to pressure palsies was suspected and confirmed by genetic test. The patient gradually recovered returning to a normal daily active life. Ultrasound was crucial for diagnosis. The suspicion and diagnosis of latent neuropathy, which can occur after surgical intervention, may lead to a better understand of the risks of the surgery, specific for the patient, and avoid the wrong attribution to surgical malpractice.
authors.affiliation: Department of Geriatrics, Neuroscience and Orthopaedics; Università Cattolica del Sacro Cuore, 1, Largo Francesco Vito, 00168 Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Logroscino
authors.affiliation: Department of Geriatrics, Neuroscience and Orthopaedics; Università Cattolica del Sacro Cuore, 1, Largo Francesco Vito, 00168 Roma, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Del Tedesco
authors.affiliation: Department of Geriatrics, Neuroscience and Orthopaedics; Università Cattolica del Sacro Cuore, 1, Largo Francesco Vito, 00168 Roma, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cambise
authors.affiliation: Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, 5, Piazzale Aldo Moro, 00185 Roma, Italy; Don Carlo Gnocchi Foundation, 6, Piazzale Morandi, 20121 Milano, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Coraci
authors.affiliation: Department of Geriatrics, Neuroscience and Orthopaedics; Università Cattolica del Sacro Cuore, 1, Largo Francesco Vito, 00168 Roma, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Donati
authors.affiliation: Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, 5, Piazzale Aldo Moro, 00185 Roma, Italy; Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, 155, Viale del Policlinico, 00161 Roma, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Santilli
authors.affiliation: Department of Geriatrics, Neuroscience and Orthopaedics; Università Cattolica del Sacro Cuore, 1, Largo Francesco Vito, 00168 Roma, Italy; Don Carlo Gnocchi Foundation, 6, Piazzale Morandi, 20121 Milano, Italy. Electronic address: lpadua@rm.unicatt.it.
authors.forename: L
authors.initials: L
authors.lastname: Padua
mesh_terms: D000368:Aged; D001176:Arthrogryposis / Q000150:complications*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015417:Hereditary Sensory and Motor Neuropathy / Q000150:complications*; D006801:Humans; D008297:Male; D010243:Paralysis / Q000209:etiology*; D010543:Peroneal Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020427:Peroneal Neuropathies / Q000209:etiology*
keywords: Hereditary neuropathy with liability to pressure palsies; Hip surgery; Nerve ultrasound; Rehabilitation