Pudendal nerve palsy as a result of traction on the fracture table (A case report).

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A Case of pudendal nerve palsy associated with intramedullary femoral fixation is reported. A 22-year-old man sustained the right femoral fracture with traffic accident. Immediately the skeletal traction with 5.5kg was done. Twelve days later, operation was performed with the patient in the lateral position on the Maquet fracture table. Open reduction was required, for closed reduction was impossible. Postoperatively the patient complained of the numbness of the right side of the penis and scrotum. He was unable to obtain an erection for three weeks. The preoperative sexual function had been normal. Two weeks later sensation gradually began to return and three months postoperatively he had normal sensation and sexual function.Since Aboulker (1974) ten cases of pudendal nerve palsies as a result of prolonged forceful traction on the fracture table have been reported in literature. A half of cases remained having some sexual dysfunction. To avoid this complication it is important to utilize the large and padded perineal post and to decrease the amount of traction.