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The Journal of Bone and Joint Surgery (American) 84:264-268 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Case Report

Gait Characteristics After Limb-Sparing Surgery with Sciatic Nerve Resection

A Report of Two Cases

Akira Kawai, MD, Takeshi Miyakawa, Masuo Senda, MD, Hirosuke Endo, MD, Noriko Naito, MD, Minori Umeda and Hajime Inoue, MD

Investigation performed at the Department of Orthopaedic Surgery, Okayama University Medical School, Okayama, Japan

Akira Kawai, MD
Masuo Senda, MD
Hirosuke Endo, MD
Noriko Naito, MD
Hajime Inoue, MD
Department of Orthopaedic Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. E-mail address for A. Kawai: akirak@md.okayama-u.ac.jp

Takeshi Miyakawa
Department of Health and Sports Science, Kawasaki University of Medical Welfare, 577 Matsushima, Kurashiki 701-0192, Japan

Minori Umeda
Okayama Southern Institute of Health, 408-1 Hirata, Okayama 700-0952, Japan

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding through the Grant-in-Aid for Cancer Research (12-11) from the Ministry of Health and Welfare. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.


   Introduction
 
Limb-sparing surgery may be considered for the treatment of soft-tissue sarcoma even when resection of a major neurovascular bundle is necessary to achieve a satisfactory surgical margin1,2. Function of an upper extremity with loss of one major nerve is often superior to function with use of a prosthesis after amputation3. In the lower extremity, limb-sparing surgery may be considered even when the sciatic nerve must be resected because of tumor involvement. Resection of the sciatic nerve results in a sensory loss distal to the knee and motor dysfunction of the knee, foot, and ankle. However, an analysis of functional loss after sciatic nerve resection for the treatment of soft-tissue sarcoma has been reported only once to our knowledge4.

We treated two patients with a soft-tissue sarcoma with a limb-sparing procedure that included resection of the sciatic nerve. During rehabilitation, both patients walked very slowly with excessive lateral . . . [Full Text of this Article]


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