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Nerve accidentally severed during Hip Reduction Surgery.
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Nerve accidentally severed during Hip Reduction Surgery.

My 6 month old daughter just had Open Reduction Hip surgery (left side only)  to correct Hip Dysplasia. During the disection process, her surgeon accidentally severed the nerve that extend the leg to the knee.  We didn't ask what the name of the nerve was, but I think it may be the fermoral nerve from the research I have done online.  The surgeon realized her mistake right away, and repaired the nerve.  She is optimistic that our daughter will recovery fully.  After reading up on nerve damage, I am really concerned about any long term damage she may experience later in life.  And given that she is only 6 months of age, it is impossible to assess whether she is experiencing any symptoms of nerve damage.  She did have an MRI 6 hours after her surgery, and the results looked promising.  Can anyone tell me whether we should be concerned about long term damage or not?  Also, what are the chances she will recover fully?  I trust our doctor, and don't hold any resentment for her mistake, but am afraid she may be sugar coating the situation until we are sure of complications. Thank you for your time, and for any advice you can provide.  Tara
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Avatar_m_tn
First of all, I am so sorry to hear about what happened to your daughter.  I can only imagine how difficult that must be.  I am not familiar with nerves in the legs, but I am all too familiar with the issues related to a severed nerve.  I was involved in a near fatal MVA on New Year's Eve of '02 during which my Ulnar nerve (funny bone) was severed 75% as a result of a bad gash in my elbow.  What I have learned over the years is that nerves are very different from other parts of our body when it comes to healing.  For instance, if I were to get a deep cut on my arm (assuming no tendons, nerves, etc were damaged) my body would have to heal at the sight of that cut, but no damage would occur to my arm above or below the sight of that cut.  However, a nerve is different.  Take me for example, my ulnar nerve was mostly severed at my elbow which meant that while the nerve was undamaged from that point UP my arm, the nerve from my elbow DOWN my arm basically died and had to re-grow.  Nerves re-grow at a fairly slow rate so I was told by the hand specialist that I was seeing that even if the surgeon did a good job of repairing the nerve (which is NOT an easy job) that by the time my nerve healed all the way down into my hand that many of the "connections" of the nerve into my muscles would be scarred over due to not being active and my muscles may therefore not return.  Not to discourage you, but I would assume that repairing the nerve in your daughter's leg was more difficult than repairing my ulnar nerve due to the fact that her nerve was completely severed whereas mine was only 75% severed.  From what I was told, a nerve is like a bundle of wires, so in repairing it a surgeon must correctly figure out which strand of wire above the cut was attached to which strand of wire below the cut.  Just for some background, it may help you to know that I wasn't treated at some small local hospital, but was transferred from the small local hospital to Dartmouth Medical Center in Hanover NH, a leading & very respected teaching hospital.   I tell you that just to say that the Dr.'s who oversaw my care were excellent Dr.'s.  Unfortunately, as the hand specialist who oversaw the healing of my ulnar nerve predicted, I did not regain full use of my hand.  I still have a good deal of numbness down the left underside of my arm and into the left side of my hand to include my pinky and ring fingers.  Although I have been incredibly blessed that my fingers did not remain in the curled "claw" position that they were in for a long time, I do not have control of those fingers for fine motor tasks (particularly my pinky as the right side of the ring finger is also controlled by the median nerve so I have more feeling & control of that finger).  If you were to make an "L" with your left pointer finger and thumb, you would have a bulge inside the 90 degree angle where the vertical & horizontal lines come together.  That bulge is of course, a muscle.  That muscle atrophied after the damage to my ulnar nerve, and as the hand specialist predicted, the connection into it was scarred over by the time the nerve regrew down into my hand and has therefore never returned.  So instead of a bulge, I have a sunken in place where that muscle used to be.  Hopefully the Dr. who did your daughter's surgery has referred you to a neurologist who can give you accurate and detailed information as to what to expect and can monitor the healing/regrowth of the nerve that was severed.  My heart goes out to you and your little girl.  I know from expereince that nerve pain is different from any other type of pain.  It is my prayer that the nerve in your little girl's leg will heal incredibly well.  At times, Dr.'s can seem to paint too rosey of a picture, but at other's they seem to present a very bleak picture.  Continue to advocate for your little girl and fight for her recovery and don't believe evertyhting the Dr.'s tell you.  Although my hand isn't quite what it used to be, the hand specialist had told me that I would likely never regain use of my hand and that has been SO far from the case.  In addition to the damage to my left arm which also included two shattered bones in my forearm, both of my legs were badly broken.  In fact, I required nearly 10 hours of surgery my first night to repair my severed nerve and broken bones.  I had a nother 3 hour surgery a few days later to do bone grafts to my right ankle which had been badly crushed. My orthopedic didn't think that I would ever walk without some form of assistance such as a cane.  Well, guess what?  I walk just fine- truly normal and no one would ever guess that I have metal implants inside 3 of my 4 limbs.  All that to say again, don't believe everything that the Dr.'s tell you.   The God of the universe who knit your little girl together can restore her body beyond what the Dr.'s say is possible.  He truly did for me.  Blessings to you and your family.  
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Avatar_m_tn
Thank you for your advice.  Your story is truly incredible. I was not aware of all that was involved in nerve recovery, and as sick as I feel right now, I am glad for your explanation.  We are due to see her surgeon again in two weeks time, so I will have many questions for her then.  So far, she has not referred us to a neurologist, but I will be sure to ask her about it.  I do know that she pulled in a Plastic Surgeon to over see the nerve repair during the surgery.  I suppose this makes sense as Plastic surgeons repair nerves more frequently than Orthopedic surgeons. They said that nerves regrow at a speed of 1mm a day, so given her size, they anticipate 30 days for a full recovery.  Also, every doctor I am spoken to thus far is optimistic for a full recovery because of her age.  Children heal so much better than we do as adults.  For the next six weeks she will be in a Hip Spica cast, which pretty much starts at her armpits and continues to her toes.  Because of this, we cannot assess whether she has full movement in that leg or not.  We can see her feet though, and she is moving her left foot normally, which I am hoping is a good sign. Thanks again for your response, I wish you all the best.
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Avatar_m_tn
I am so glad to hear that the Dr. expects your daughter's nerve to have healed fully in 30 days.  That is great news & I am pleased to hear that she has good movement in her foot.  I wish you and your little one all the best!
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