International Journal of Orthopaedics Sciences

International Journal of Orthopaedics Sciences

2023, Volume 9 Issue 1

Perineal compression in patients undergoing internal fixation of femur fractures: A cause for erectile dysfunction

Author(s): Dr. G Vignesh, Dr. N Adhishwar Kumaran, Dr. Aakash, Dr. Arun Vignesh and Dr. Yeshwanth Subash
Abstract: 
Introduction: Pudendal nerve trauma is a rare complication of orthopedic surgery, which usually occurs after traction of the pelvis on an orthopedic table fitted with a pelvic support. This trauma is thought to be due to crushing of the nerve against the perineal post or stretching of the Pudendal nerve due to excessive traction during fixation of fractures of femur. Usually it resolves spontaneously or can even persist. The prognosis depends on the severity of the symptoms.
Materials and Methods: This was a prospective study conducted between 30 participants. Patients who had femur fractures operated in fracture table were included in this study. Patients who had no h/o erectile dysfunction, sexually active male were the inclusion criteria. All patients were assessed for erectile dysfunction following surgery and followed up till recovery.
Results: 4 Patient gave history of occasional erection of penis – 3 to 4 times before full recovery, which was not suitable for penetration. Patients also gave history of no morning erections. All Patient had no history of erectile dysfunction before surgery. 8 Patient underwent office sildenafil test- tab. sildenafil 50mg stat in quiet comfortable room and observed for erection. One dose of 50 mg of Phosphodiesterase inhibitors was used whenever necessary and showed satisfying results in all patients.
Conclusion: Duration of surgery was also a contributing factor for recovery. Based on the above data, in longer duration of surgery the recovery was late. In surgically management femoral fractures, prolonged traction may be the causative factor in erectile dysfunction. Certain Strategies should be carried out to avoid perineal compression such as, distributing traction on the perineum by using a wide perineal post which is well padded, to reduce muscle tone and shorter surgery duration.
Pages: 86-89  |  12 Views  1 Downloads
How to cite this article:
Dr. G Vignesh, Dr. N Adhishwar Kumaran, Dr. Aakash, Dr. Arun Vignesh, Dr. Yeshwanth Subash. Perineal compression in patients undergoing internal fixation of femur fractures: A cause for erectile dysfunction. Int J Orthop Sci 2023;9(1):86-89. DOI: 10.22271/ortho.2023.v9.i1b.3280
International Journal of Orthopaedics Sciences
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