The Journal of Bone and Joint Surgery, Vol 75, Issue 8 1157-1166, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Injury of the sciatic nerve associated with acetabular fracture
PR Fassler, MF Swiontkowski, AW Kilroy and ML Routt
Vanderbilt University Medical Center, Nashville, Tennessee.
In order to document functional outcome, we followed fourteen patients who
had an injury of the sciatic nerve associated with a displaced acetabular
fracture for a mean of twenty-seven months. In three of the patients, the
injury was iatrogenic. Electromyography was useful in the localization and
determination of the severity of the injury. According to the functional
scale that was used, all but one patient had a satisfactory (fair or
better) functional outcome, but eleven patients had residual neurological
sequelae that ranged from minor paresthesia to footdrop. Seven patients who
had an injury of both the tibial and peroneal divisions of the sciatic
nerve had complete or nearly complete motor and sensory recovery of the
tibial component. The patients who had isolated, mild involvement of the
peroneal nerve had a favorable prognosis, but those who had a severe injury
of the peroneal component, whether it was isolated or associated with an
injury of the tibial component, did not recover good function.