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Review Question - QID 162

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QID 162 (Type "162" in App Search)
A 25-year-old patient presents with a posterior wall/ posterior column acetabular fracture. She is scheduled for open reduction internal fixation through a posterior approach. What position of the leg exerts the least amount of intraneural pressure on the sciatic nerve?

hip flexion, knee extension

2%

43/2857

hip extension, knee extension

3%

78/2857

hip flexion, knee flexion

5%

154/2857

hip extension, knee flexion

90%

2561/2857

the pressure does not vary based on position

0%

9/2857

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In the cited study, researchers measured tissue fluid pressure within the sciatic nerve in cadaveric specimens using a pressure transducer. The hip and knee were taken through a combination of ranges and found that the clinically relevant increase in pressure happened with the hip flexed at 90 degrees and the knee fully extended. They concluded that increased intraneural pressure was related to excursion of the nerve as linear distance between the greater sciatic notch and the distal leg increase. Hence, according to the question stem, to avoid traction injury, the reverse position should be implemented (hip extension and knee flexion).

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