Complete sciatic nerve palsy after open femur fracture: successful treatment with neurolysis 6 months after injury.
Although relatively uncommon, peripheral nerve can be injured secondary to fracture or dislocation. As therapeutic strategies may vary with the status of the nerve involved, accurate diagnosis is critical. The case described in this report involves a complete sciatic nerve palsy occurring after an open femur fracture treated 6 months earlier. The palsy was erroneously attributed to ischemic neuropathy from compartment syndrome, but late surgical exploration showed that the sciatic nerve was in continuity but enveloped by scar. Neurolysis resulted in full motor and sensory recovery below the knee. Accurate interpretation of physical findings and neurophysiologic tests in the management of fractures associated with nerve injury is emphasized.
Tomaino
Matthew M
MM
Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA.
D000063:Accidents, Traffic; D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D004558:Electric Stimulation; D004576:Electromyography; D005264:Femoral Fractures / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D005597:Fractures, Open / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D020127:Recovery of Function; D020426:Sciatic Neuropathy / Q000209:etiology / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome