Retroperitoneal Femoral Nerve Reconstruction in the Pediatric Population
Bibliographic record
Abstract
BACKGROUND: Retroperitoneal femoral nerve lesions in children are rare. They can result in a complete femoral nerve palsy causing severe functional impairment of ambulation and standing and sensory impairment of the anterior and medial thigh extending down the medial aspect of the leg. While treatment can be challenging due to the complex anatomy of the region and the difficulty of achieving adequate surgical access, femoral nerve repair has lead to the recovery of useful function in adult patients. OBJECTIVE: The authors review their experience from the surgical treatment of three consecutive cases of this rare lesion in children while focusing on validated outcome measures. METHODS: A retrospective chart review of all cases of retroperitoneal femoral nerve transection treated surgically was completed (n=3). Data collected included demographics, timing of repair, surgical approach, Medical Research Council muscle grading scores, the Hospital for Sick Children Active Movement Scale scores and follow-up period. RESULTS: Follow-up ranged from two to 4.5 years. All three patients had excellent motor recovery and ambulated without assistance. Sensory function also improved, with a substantial resolution of preoperative dysesthesia in one case. There were no major complications. CONCLUSIONS: Complete retroperitoneal femoral nerve transection in children is a rare but devastating injury. Appropriate surgical access to the retroperitoneal space is a prerequisite for lumbar plexus reconstruction and mandates a team approach. In the present series, all patients regained excellent function following reconstruction. The surgical treatment of these unusual lesions in childhood proved highly rewarding.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".