Abstract
A 29-year-old teacher, presented with right medial patellofemoral ligament (MPFL) tear. This was identified and confirmed by magnetic imaging resonance and MPFL was reconstructed with gracilis tendon. She had femoral nerve palsy that recovered fully after prolonged rehabilitation.
Highlights
ConclusionFemoral nerve palsy secondary to pneumatic pressure is uncommon
Pneumatic tourniquets are used to provide bloodless surgical field and minimize blood loss [1,2]
Iatrogenic femoral nerve palsy as a result of tourniquet use is uncommon [3,4,5]. This may be underreported because of weakness of the quadriceps muscle from the surgical procedure and rapid recovery of the nerve [3]. Both ischemic and mechanical processes have been implicated in the pathophysiology of the femoral nerve palsy [2,6,7,8,9]
Summary
Neurapraxia of the femoral nerve secondary to pneumatic tourniquet are uncommon. There is no universal adopted safe tourniquet time and pressure. Prevention of this complication by inflating pneumatic tourniquet to above 100150mmHg of systolic high blood pressure and not more than 300mmHg for not more than 2 hours continuously should be adhered to at all times. Extra caution in patients with low body fat percentage and high muscle content must be taken by applying lower pneumatic pressures to avoid additive compression of the nerve by muscle
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