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Complications of the hamstring ligament reconstruction:

Print Article

Technical hamstring ligament or DT 4 or hamstring

Complications of the hamstring ligament reconstruction:

Statistics show few complications that although they are rare, constant concern to the medical team. This risk explains that some examinations and / or complementary treatments are prescribed

 

Intraoperative risks:

 

Anesthetic risks are explained in the consultation for preoperative anesthesia is required at least 48 hours prior to the intervention. (except for emergencies)

 

Withers risks: the tourniquet can be responsible for local cutaneous or neurological disorders, usually regressive. These complications are preventable systematic protection of the skin and continuous monitoring of the pressure of the withers.

 

Risks related to the surgical technique: some cases of pain at the donor site hamstring and bone cracking on the femur or tibia bone tunnels in the transplant receivers. These lesions are usually benign but can cause the surgeon to use other incisions and possibly of osteosynthesis material (screws, clip) to treat them.

 

Of tendon-muscle secondary lesions have also been described at the graft harvest site (tendinitis, tendon rupture) may require special treatment.

 

Severe damage to vascular or neurological injury are reported very rarely in the French and international literature. They need urgent treatment, the consequences can be very serious and penalizing.

 

Postoperative risks:

 

The joint infection is very rare less than 0.37% of cases. A joint exhibiting in the days after surgery, swelling, inflammatory signs and possibly partnering with fever, should suggest this complication. It requires emergency treatment. These risks are minimized by strict aseptic protocols before, during and after surgery and intraoperative antiobioprophylaxie according to the protocol of the CLIN (Committee for the Fight against nosocomial infections).

 

Venous thrombosis or phlebitis of the lower limb is rare but can occur, usually favored by a particular field. It is the subject of preventive treatment with anticoagulant sting

 

Hemarthrosis (intra-articular bleeding) results in the rapid onset of a power effusion which can be very painful. It is linked to either a bleeding in the path of the incision, or bleeding of an intra-articular structure. Sometimes it is necessary to wash the joint block to relieve the patient.

 

The diffuse subcutaneous hematoma often results in delayed onset and progressive a subcutaneous hematoma is often little painful but very impressive. A simple rest, icing and elevation of the lower limb used to make disappear 2to 3 weeks.

 

Scars can be the seat of small local redness problems, delayed wound healing. It is not uncommon to note the presence of a small subcutaneous hematoma surrounding the scar and down on the leg and back of the knee. These hematomas resolve spontaneously within weeks. Finally, can occur unpleasant sensations of dysesthesia, paresthesia or anesthesia skin near the incision means any incision in the skin causes the nervous micro thread section, which cause these sensory disorders generally very localized and usually regressive within months.

 

Algodystrophy is a painful reaction and enraidissant of articulation, of unknown origin, which can occur after any surgery. It can significantly extend in the suites and leave sequelae persist (pain, partial loss of mobility, adaptive difficulty effort)

 

The "working cyclop"is a deficit of full extension of the knee, resulting in a process of healing own exuberant in some individuals. This syndrome causes a delay recovery with a mechanical locking sensation in front of the knee. It can cause the surgeon to carry out a new arthroscopic knee to release this excess scarring, though rarely before 6 th postoperative month.

 

Failed Registry for mechanical or biological, the ligament graft may break or necrotic, thus losing its effectiveness, can reproduce the initial symptoms. Reoperation can then be discussed.

 

 

Doctor Nicolas LEFEVRE, Doctor Yoann BOHU, Doctor Serge HERMAN. - 25 d├ęcembre 2014.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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