title: Nerve Palsy after Total Hip Arthroplasty without Subtrochanteric Femoral Shortening Osteotomy for a Completely Dislocated Hip Joint.
abstract: BACKGROUND
  Neurological injuries are a rare but devastating complication after total hip arthroplasty (THA). The purpose of this study was to retrospectively determine the frequency of nerve palsy after THA without subtrochanteric femoral shortening osteotomy in patients with a completely dislocated hip joint without pseudo-articulation between the femoral head and iliac bone.
  
  
  METHODS
  Between October 1999 and September 2001, nine primary THAs were performed for patients with a completely dislocated hip joint. The limb lengths, neurological abnormalities, and the extent of their neurological recovery were evaluated. Three THAs were combined with subtrochanteric femoral shortening osteotomy, and six THAs were combined without subtrochanteric femoral shortening osteotomy.
  
  
  RESULTS
  The mean length of the operation was 4.8 cm (range, 3.0-6.5 cm). Sciatic nerve palsy developed in four of the nine patients after THA. None of the cases with sciatic nerve palsy were combined with subtrochanteric femoral shortening osteotomy. Three of four patients did not completely recover from sciatic nerve palsy.
  
  
  CONCLUSIONS
  THA for patients with a completely dislocated hip was associated with a high risk of nerve palsy due to excessive limb lengthening; the potential for recovery from nerve palsy was observed to be poor. Subtrochanteric femoral shortening osteotomy should be used in combination with THA in patients with a completely dislocated hip.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Saga, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Sonohata
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Saga, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Saga, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Saga, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mawatari
keywords: Completely Dislocated Hip Joint; Developmental Dysplasia of the Hip; Nerve Palsy; Subtrochanteric Osteotomy; Total Hip Arthroplasty