Femoral, saphenous nerve palsy after tourniquet use: a case report1


      Kornbluth ID, Freedman MK, Sher L, Frederick RW. Femoral, saphenous nerve palsy after tourniquet use: a case report.
      Persistent motor and sensory abnormalities after surgery may affect the rehabilitation process. Patients with continued weakness may be perceived as lacking motivation by health care providers. However, there may be an underlying pathophysiologic abnormality preventing patients from progressing through their rehabilitation programs. We report a case of a 20-year-old man who underwent surgical repair of multiple knee structures with the use of a pneumatic tourniquet. Several weeks after surgery, electromyographic evaluation was done because he was having difficulty in his rehabilitation because of persistent weakness. An electromyography and nerve conduction study (NCS) revealed femoral and saphenous nerve palsies. Our report is the first on tourniquet-induced saphenous nerve injury as well as on abnormal femoral NCSs caused by tourniquet use. A review of the literature indicates that tourniquet-induced nerve palsies are not a rare event. Further evaluation should be considered if patients who are having persistent weakness or sensory findings after surgery have used a tourniquet.


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        • Fletcher I.R.
        • Healy T.E.
        The arterial tourniquet.
        Ann R Coll Surg Engl. 1983; 65: 409-417
        • Love B.R.
        The tourniquet.
        Aust N Z J Surg. 1978; 48: 66-70
        • DiStefano V.J.
        • Kalman V.R.
        • O’Malley J.S.
        Femoral nerve palsy after arthroscopic surgery with an infusion pump irrigation system. A report of three cases.
        Am J Orthop. 1996; 25: 145-148
        • Celebrezze Jr, J.P.
        • Pidala M.J.
        • Porter J.A.
        • Slezak F.A.
        Femoral neuropathy.
        Dis Colon Rectum. 2000; 43: 419-422
        • Dobner J.J.
        • Nitz A.J.
        Postmeniscectomy tourniquet palsy and functional sequelae.
        Am J Sports Med. 1982; 10: 211-214
        • Reid H.S.
        • Camp R.A.
        • Jacob W.H.
        Tourniquet hemostasis. A clinical study.
        Clin Orthop. 1983; Jul-Aug: 230-234
        • Saunders K.C.
        • Louis D.L.
        • Weingarden S.I.
        • Waylonis G.W.
        Effect of tourniquet time on postoperative quadriceps function.
        Clin Orthop. 1979; Sep: 194-199
        • Rorabeck C.H.
        • Kennedy J.C.
        Tourniquet-induced nerve ischemia complicating knee ligament surgery.
        Am J Sports Med. 1980; 8: 98-102
        • Fox I.M.
        • Mandracchia V.
        • Jassen M.
        • Chu J.
        The pneumatic tourniquet in extremity surgery.
        J Am Podiatry Assoc. 1981; 71: 237-242
        • Hoyer A.
        • Eickhoff W.
        • Rumberger E.
        Alterations in electromyograms due to inactivity-induced atrophy of the human muscle.
        Electromyogr Clin Neurophysiol. 2000; 40: 267-274
        • Middelton R.W.
        • Varian J.P.
        Tourniquet paralysis.
        Aust N Z J Surg. 1974; 44: 124-128
        • Gutin B.
        • Warren R.
        • Wickiewicz T.
        • O’Brien S.
        • Altchek D.
        • Kroll M.
        Does tourniquet use during arthroscopic cruciate ligament surgery interfere with postsurgical recovery of function? A review of the literature.
        Arthroscopy. 1991; 7: 52-56
        • Guanche C.A.
        Tourniquet-induced tibial nerve palsy complicating anterior cruciate ligament reconstruction.
        Arthroscopy. 1995; 11: 620-622