femoral nerve injury

[hipgirl]

Status post revision THR at 12 weeks. Still no return of motor function to quadriceps. Some sensory return from above knee to below knee. Surgeon claims a "stretch injury" from retractor but I am thinking a "stretch injury" would be better by now. Physiatrist says nerve regrowth occurs at 1mm/month. Should I freak out yet or am I just being impatient? I am scheduled for another EMG in 5 weeks. When can I expect return of motor function? Why is the sensory deficit abating slightly when I can't move my quad. Any advice? Many thanks!

[robinlynn1966]

I am having the exact same problem.  nerve conduction test abnormal and emg showing short circut to  quads.  entire area of the front of leg numb from hip to ankle (the "asleep") kind of numb.  can not move quads at all, they are already starting to atrophy,  emg was at 4 weeks post op.  also have developed a joint effusion and bakers cyst in knee of operative leg that was not there prior to surgery.  surgeon wanted to blame on anesthesia for the nerve root block but emg rules that out.  i too am very frustrated as no one wants to fix and they just "hope" it will get better .  i guess because they are almighty dr's they do not have to answer for possibly putting me in a brace for the rest of my life.  what ever happened to "first do no harm"??
  any help or answers would be very much appreciated.  they can be emailed to ***@****

[hipgirl]

I had an EMG at 7 weeks (surgeon was in wait and see mode - I wasn't) and have another scheduled at17 weeks post surgically. The report doesn't quantify the type of injury, but a type I injury would be healing faster I suspect. The physiatrist wondered if a tourniquet had been used, and his quote to the ordering physician was "I hope it will recover", I do hospital risk management by trade and that did not seem an optimistic note, what he said to me was "I see no reason it shouldn't recover"(definitely more hopeful-), can he specifically tell from the EMG?. The surgeon says it is not a tourniquet injury, he is certain it is a retractor injury -  (points given for that admission!) consistent with neuropraxia. Anyway the physiatrist time estimate for repair is more consistent with an axonotmetic injury versus neuropraxia. Would the EMG have been able to specifically quantify that? I am just worried it is worse than they are saying. Does motor function normally return after the sensory function? I am going to PT and getting e-stim. Thanks!!

[Abhijeet Deshmukh, MD]

Hello.

Femoral nerve injury can occur after surgical procedures on the hip. The stretch injury has to be quantified. I hope the nerve is not damaged badly. Since the sensory functions are returning, it seems the nerve is not severed.

It does grow at the speed of 1mm/month, but the situations are normal. In case of an injury, the speed of growth could be variable. An EMG should ideally be done 4 weeks post surgery or onset of weakness. Was an EMG done in these 12 weeks?

Physical therapy is a key to recovery.

Regards