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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obturator neuropathy is an infrequently identified complication of total hip replacement that may cause debilitating pain. There have been isolated reports of this complication in the literature, but only one case has been published in which intrapelvic cement was the causative agent. We are describing the cases of four patients with obturator neuropathy after total hip replacement, documented by electromyography and attributed to intrapelvic extension of cement. In each patient the source of the symptoms was not initially apparent. In three of the patients the extruded cement and obturator nerve were explored surgically. One of the three patients was improved by obturator neurectomy. Of the other two patients, both treated by excision of cement, only one was improved. The fourth patient was not treated. Persistent pain in the groin and thigh, intrapelvic cement visible on plain roentgenograms, and adductor weakness after total hip replacement suggest that this complication has occurred. Electromyography can confirm the presence of obturator neuropathy. Based on this limited series, excision of the extruded cement and preservation of the nerve should be attempted only when the nerve is grossly normal and functional as determined by electrical stimulation at the time of surgical exploration; otherwise, obturator neurectomy should be considered.
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PMID:Obturator-nerve palsy resulting from intrapelvic extrusion of cement during total hip replacement. Report of four cases. 405 47

Compression of a peripheral nerve or nerve trunk can occur during pregnancy and delivery. The injury may be caused by the fetal head, the application of forceps, trauma or hematoma due to cesarean section, or improper positioning in leg holders. Often, no cause of the injury is found. The most common nerve compression syndromes during pregnancy and delivery are carpal tunnel syndrome, femoral neuropathy, and post partal foot drop. Obturator neuropathy, meralgia paraesthetica, tarsal tunnel syndrome, and syndrome of the rectus abdominis muscle occur less frequently. Symptoms, such as paraesthesia, pain and palsies not always attract the immediate attention of the physician. Sometimes they are misinterpreted as nervous complaints. Often, remission is reached at delivery. A case of obturator neuropathy after delivery is reported, and literature on clinical, pathophysiological and electrophysiological findings in maternal obstetric palsies is reviewed.
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PMID:[Postpartum obturator nerve syndrome: case report and review of the nerve compression syndrome during pregnancy and delivery]. 917 73

Obturator neuropathy is a difficult clinical problem to evaluate. One possible cause of pain is due to fascial entrapment of the nerve. Symptoms include medial thigh or groin pain, weakness with leg adduction, and sensory loss in the medial thigh of the affected side. Radiographic imaging provides limited diagnostic help. MRI may detect atrophy in the adductors of the leg. However, it is unable to detect any abnormality of the nerve or in the fibro-osseus tunnel. The best test for diagnosis is by electromyography (EMG) and can be confirmed by a local nerve block. Pharmacologic management of pain and physical therapy can be helpful in the acute phase of injury. Surgical decompression of the nerve should be considered for lesions documented by EMG or local nerve block, for those with predisposing risk factors (prior surgery, pelvic trauma, or hematoma) and with prolonged or severe lesions.
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PMID:Obturator neuropathy. 1946 9

Obturator neuropathy is a cause of exercise-related groin pain, particularly in those who play sports that involve much running, twisting and turning, and kicking. Symptoms include pain that begins insidiously at the adductor origin on the pubic bone and worsens with exercise. Diagnostic measures include reproduction of pain by stretching the pectineus muscle after exercise, electromyography, and a local anesthetic block of the obturator nerve. Surgery allows most patients to resume previous levels of activity.
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PMID:Obturator neuropathy: a cause of exercise-related groin pain. 2008 19