Schwangerschafts-induzierte Nervus femoralis-Läsion

Self-selection of gestational lumbopelvic posture and bipedal evolution

BACKGROUND

Not all pregnant women seem to select the more curved lumbopelvic posture that their sexual dimorphic anatomy allows even though many previous researchers have assumed lumbopelvic curvature to be standard during pregnancy. This study is vital to understanding coevolution of lumbopelvic sexual dimorphism and bipedalism, and understanding some clinical implications of intervening in gestational posture changes.

RESEARCH QUESTIONS

Are there anthropometric changes that correspond with selection of lumbopelvic curvature change during pregnancy? What are the biomechanical costs and benefits of gestational lumbopelvic curvature change?

METHODS

Twenty pregnant women were tested at five different times in the 2nd and 3rd trimesters of pregnancy. Lumbopelvic posture, standing kinetics and gait kinetics were measured longitudinally. Additionally, we modeled the effects on standing and gait without lumbopelvic postural changes, but with anthropometric changes, for each individual.

RESULTS

We found greater lumbopelvic angulation to correspond with a shorter body height (6 cm difference between groups, p = 0.048) and deeper 2nd trimester abdomen (2 cm difference between groups, p = 0.013). Lumbopelvic angulation lowers support requirements (in standing and walking (6% lower support impulse, p = 0.056), but at the cost of shifting the propulsive actions to a less efficient pulling action rather than pushoff (13 % reduction in pushoff time, p = 0.001). We observed minimal effects on walking kinematics and balance control.

SIGNIFICANCE

Our findings suggest the evolutionary advantage of the female lumbopelvic unit is the adaptability it provides to adjust for the individual needs of the pregnant woman. We discuss multiple potential contributing factors that may have shaped hominin female lumbopelvic evolution and are involved in self-selecting lumbopelvic posture.

Bone lymphoma revealed by cruralgia during pregnancy: a case report

Pregnancy complicated by Non Hodgkin lymphoma (NHL) is rare, about 100 cases have been reported. We will describe the case of a multifocal bone lymphoma revealed by a left hyperalgetic and deficient cruralgia in a female in the second trimester of pregnancy.

Femoral nerve entrapment: A new insight

Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.