Femoral Head and Neck Excision Complicated by Ischiatic Nerve Entrapment in Two Dogs

Summary

Two dogs, both Doberman n pinschers, developed ischiatic nerve palsy following femoral head and neck excisions. Each had undergone surgery entailing the incorporation of a muscle flap (in one case deep gluteal, in the other biceps femoris) to reduce bone-on-bone contact after ostectomy. At later exploratory surgery, the ischiatic nerve was found to be entrapped by muscle in the ischiatic fossa, caudal to the greater trochanter. Partial excision of the ischium relieved the compression, allowing rapid recovery of function. The complication of ischiatic nerve entrapment may warrant consideration when contemplating femoral head and neck excision in cases in which the greater trochanter and ischial tuberosity are abnormally close.

Ischiatic nerve palsy developed several weeks after femoral head and neck excision in two Dobermann pinschers. Both dogs had undergone surgery involving muscle sling placement. The ischiatic nerve was found to be entrapped in muscle in each case. Resection of portions of the ischium allowed rapid recovery of function.

Keywords

Femoral head and neck excision - ischiatic nerve palsy - ostectomy

• REFERENCES

• 1 Brinker WO, Piermattei DL, Flo GL. Femoral head and neck excision. In: Hand-book of Small Animal Orthopaedics and Fracture Treatment. Philadelphia: Saunders; 1983: 286-9.
• 2 Duff R, Campbell JR. Long term results of excision arthroplasty of the canine hip. Veterinary Record 1977; 101: 181-4.
• 3 Berzon JL, Howard PE, Covell SJ, Trotter EJ, Dueland R. A retrospective study of the efficacy of femoral head and neck excisions in 94 dogs and cats. Vet Surg 1980; 9: 88-92.
• 4 Lippincott CL. Improvement of excision arthroplasty of the femoral head and neck utilising a biceps femoris muscle sling. J Anim Hosp Assoc 1981; 17: 668-72.
• 5 Lippincott CL. Excision arthroplasty of the femoral head and neck utilising a biceps femoris sling. Part two: the caudal pass. J Am Anim Hosp Assoc 1984; 20: 377-84.
• 6 Bjorling DE, Chambers JN. The biceps femoris flap and femoral head and neck excision in dogs. Compendium on continuing Education 1986; 8: 359-63.
• 7 Lewis DD, Bellah McGavin MD, Gaskin JM. Post operative examination of the biceps femoris muscle sling used in excision of the femoral head and neck in dogs. Vet Surg 1988; 17: 269-77.
• 8 Stanton ME, Weigel JP, Henry RE. Ischiatic nerve paralysis associated with the biceps muscle sling: case report and anatomical study. J Am Anim Hosp Assoc 1988; 24: 429-32.
• 9 Mann FA, Tangner CH, Wagner-Mann C. et al. A comparison of standard femoral head and neck excision and femoral head and neck excision using a biceps femoris muscle flap in the dog. Vet Surg 1987; 16: 223-30.
• 10 Lippincott CL. Femoral head and neck excision in the management of canine hip dysplasia. Vet Clin North Am 1992; 22: 721-38.
• 11 Prostedney JM, Toombs JP, VanSickle DC. Effect of two muscle sling techniques on early morbidity after femoral head and neck excision in dogs. Vet Surg 1991; 20: 298-305.
• 12 Withrow SJ, Amis TC. Sciatic nerve injury associated with intramedullary fixation of femoral fractures. J Am Anim Hosp Assoc 1977; 13: 562-8.
• 13 Newton GT. Sciatic impairment following proximal femoral physeal fracture: two case reports. J Am Anim Hosp Assoc 1989; 25: 239-42.
• 14 Walker TL. Ischiadic nerve entrapment. J Am Vet Med Assoc 1981; 178: 1284-8.
• 15 Gilmore DR. Sciatic nerve injury in twenty nine dogs. J Am Anim Hosp Assoc 1984; 20: 403-12.