{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T04:51:37Z","timestamp":1774155097774,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Position-related compressive nerve injury is a frequently reported complication of the lithotomy position. In contrast, compartment syndrome-induced neuropathy after lithotomy with prolonged surgery is rare and prone to misdiagnosis. This case describes the successful open decompression of sciatic neuropathy due to compartment syndrome after a prolonged lithotomy position. Case presentation: A 56-year-old male patient complained of an abnormal sensation in the lower leg and difficulty in dorsiflexion and plantarflexion of the left foot and toes after laparoscopic anterior hepatic sectionectomy for 16 h in a lithotomy position. Physical examination revealed severe pain and paresthesia below the distal left thigh. In manual muscle test grading, dorsiflexion and plantarflexion of the left ankle and toes were classified as grade 1. Computed tomography and magnetic resonance imaging showed ischemic changes in the mid-thigh posterior muscles, and the sciatic nerve was severely swollen at the distal thigh, which was compressed by the proximal edge of the well-leg holder. After debridement of the necrotic tissue and decompression of the sciatic nerve, the pain subsided immediately, and the ankle and toe dorsiflexion motor function improved to grade 4. Conclusions: Most case reports of compressive neuropathy associated with the lithotomy position have been related to conservative treatment. However, if a lesion compressing the nerve is confirmed in an imaging study and the correlation with the patient\u2019s symptoms is evident, early surgical intervention can be an effective treatment method to minimize neurological deficits.<\/jats:p>","DOI":"10.3390\/medicina58101497","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T06:37:45Z","timestamp":1666593465000},"page":"1497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Open Sciatic Nerve Decompression for Compartment Syndrome after Prolonged Lithotomy Position: A Case Report"],"prefix":"10.3390","volume":"58","author":[{"given":"Se-Hwan","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Pil","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-6863","authenticated-orcid":false,"given":"Sun-Jung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/00000542-199407000-00004","article-title":"Lower-extremity Motor Neuropathy Associated with Surgery Performed on Patients in a Lithotomy Position","volume":"81","author":"Warner","year":"1994","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1007\/s10350-006-0712-1","article-title":"Lower Limb Acute Compartment Syndrome After Colorectal Surgery in Prolonged Lithotomy Position","volume":"49","author":"Beraldo","year":"2006","journal-title":"Dis. Colon Rectum"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.17.00016","article-title":"The Diagnosis of Acute Compartment Syndrome: A Critical Analysis Review","volume":"5","author":"Duckworth","year":"2017","journal-title":"JBJS Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/j.1463-1318.2010.02314.x","article-title":"Lithotomy-related neurovascular complications in the lower limbs after colorectal surgery","volume":"13","author":"Sajid","year":"2011","journal-title":"Color. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/00005131-200003000-00001","article-title":"Well-Leg Compartment Pressures During Hemilithotomy Position for Fracture Fixation","volume":"14","author":"Tan","year":"2000","journal-title":"J. Orthop. Trauma"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.2106\/00004623-200210000-00014","article-title":"Intramuscular and blood pressures in legs positioned in the hemilithotomy position: Clarification of risk factors for well-leg acute compartment syn-drome","volume":"84","author":"Meyer","year":"2002","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0140-6736(54)91258-1","article-title":"Postural Isch\u00e6mia and Blood-Pressure","volume":"263","author":"Enderby","year":"1954","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/00005131-200209000-00006","article-title":"The clinical diagnosis of compartment syndrome of the lower leg: Are clinical findings predictive of the disorder?","volume":"16","author":"Ulmer","year":"2002","journal-title":"J. Orthop. Trauma"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.5435\/JAAOS-D-19-00270","article-title":"Management of Acute Compartment Syndrome","volume":"28","author":"Osborn","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5704\/MOJ.2003.001","article-title":"The Use of Alfa-Lipoic Acid-R (ALA-R) in Patients with Mild-Moderate Carpal Tunnel Syndrome: A Randomised Controlled Open Label Prospective Study","volume":"14","author":"Passiatore","year":"2020","journal-title":"Malays. Orthop. J."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/10\/1497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:58:45Z","timestamp":1760144325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/10\/1497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["medicina58101497"],"URL":"https:\/\/doi.org\/10.3390\/medicina58101497","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]}}}