Karl Schwaiger1, P Pumberger2, J Wimbauer2, E Russe2, G Schaffler3, G Wechselberger2. 1. Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Krankenhaus der Barmherzigen Brüder Salzburg, Paracelsus Medizinische Privatuniversität Salzburg, Kajetanerplatz 1, 5020, Salzburg, Österreich. karl.schwaiger@outlook.com. 2. Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Krankenhaus der Barmherzigen Brüder Salzburg, Paracelsus Medizinische Privatuniversität Salzburg, Kajetanerplatz 1, 5020, Salzburg, Österreich. 3. Abteilung für Radiologie, Krankenhaus der Barmherzigen Brüder Salzburg, Kajetanerplatz 1, 5020, Salzburg, Österreich.
Abstract
OBJECTIVE: Treatment of non-responding pain to conservative treatment located at the anterolateral thigh with surgical decompression of the lateral femoral cutaneous nerve of the thigh (LFCN). INDICATIONS: Compression syndrome of the LFCN; patients suffering from the following symptoms: pain (dysesthesia), numbness (paresthesia), hypersensibility to temperature (or temperature changes) along the course of the LFCN located at the anterolateral thigh. CONTRAINDICATIONS: A new or recrudescent hernia with additional pain or recent laparoscopic hernia repair as a supposed iatrogenically induced compression of the LFCN. SURGICAL TECHNIQUE: Dissection and release of the LFCN of connective tissue, scar tissue, bone rims, and retraction located along the passage underneath the inguinal ligament and distally. POSTOPERATIVE MANAGEMENT: Suture removal after 10-14 days, no sports for 2 weeks. Physiotherapy if necessary. Neurography 4 months after surgery (obligatory if symptoms are persistent). The patient should be followed up for about 24 months. RESULTS: Of the patients, 69% had a history of trauma or surgery, which were designated as the onset of pain. Of these patients, 78% had hip prostheses and 22% had previous falls. Postoperatively, a significant reduction of pain of 6.6 points on the numeric rating scale was observed. All other evaluated parameters also improved postoperatively. Patient satisfaction was high, with 86% reporting complete satisfaction, and 14% reporting partial satisfaction.
OBJECTIVE: Treatment of non-responding pain to conservative treatment located at the anterolateral thigh with surgical decompression of the lateral femoral cutaneous nerve of the thigh (LFCN). INDICATIONS: Compression syndrome of the LFCN; patients suffering from the following symptoms: pain (dysesthesia), numbness (paresthesia), hypersensibility to temperature (or temperature changes) along the course of the LFCN located at the anterolateral thigh. CONTRAINDICATIONS: A new or recrudescent hernia with additional pain or recent laparoscopic hernia repair as a supposed iatrogenically induced compression of the LFCN. SURGICAL TECHNIQUE: Dissection and release of the LFCN of connective tissue, scar tissue, bone rims, and retraction located along the passage underneath the inguinal ligament and distally. POSTOPERATIVE MANAGEMENT: Suture removal after 10-14 days, no sports for 2 weeks. Physiotherapy if necessary. Neurography 4 months after surgery (obligatory if symptoms are persistent). The patient should be followed up for about 24 months. RESULTS: Of the patients, 69% had a history of trauma or surgery, which were designated as the onset of pain. Of these patients, 78% had hip prostheses and 22% had previous falls. Postoperatively, a significant reduction of pain of 6.6 points on the numeric rating scale was observed. All other evaluated parameters also improved postoperatively. Patient satisfaction was high, with 86% reporting complete satisfaction, and 14% reporting partial satisfaction.