This case involves a patient who was admitted to the hospital for an elective total left hip replacement. After surgery, the patient complained of an inability to flex or extend their left ankle. The impression in the medical note was that there was a postoperative foot drop associated with numbness on the dorsal aspect of the foot. A neurology consult and further imaging studies were ordered to evaluate the possibility of any nerve damage from the surgery. An EMG showed a left sciatic mononeuropathy with the lesion predominantly affecting the peroneal fibers. Additionally, an MRI showed that there was a large neuroma formation of the sciatic nerve at the level of the femoral neck with surrounding scar encasement. The plaintiff claims that the surgeon lacerated this nerve, after the plaintiff consulted other surgeons who attribute the neuroma formation to a damaged nerve.
Question(s) For Expert Witness
- Is this a recognized complication given the anterior approach, and does the presence of a neuroma formation suggest that a laceration to the nerve occurred during this procedure?