[Surgical treatment of shotgun injuries of the sciatic nerve].
OBJECTIVE
To explore the clinical characteristics and the effect of surgical therapy for shotgun injuries of the sciatic nerve.


METHODS
From 1996 to 2000, 19 sciatic nerve injuries resulted from shotgun were observed. Among 19 cases of shotgun sciatic nerve wounds, the gluteal wound was in 2 cases, thigh wound in 15 cases, and knee wound in 2 cases. The firing distance was between 0.5-9 m. According to Shermen classification of shotgun injury, 4 cases belonged to type I injury, 11 cases type II, 4 cases type III. The time from injury to admission was between 2 months-14 months except 1 patient who underwent emergency operation 4 hours after injury, and 1 patient was treated with debridement and epineurial neurorrhaphy, 7 cases with nerve trunk grafting, 6 cases with nerve cable grafting, 4 cases with neurolysis, 1 case with arthrodesis of ankle.


RESULTS
Nineteen cases were followed-up for 0.8-3.5 years (mean, 19 months). The excellent and good nerve functional recovery was found in 52.6% according to MCRR.


CONCLUSIONS
Shotgun injuries of the sciatic nerve are very severe and complicated, and injuries in most patients were usually complicated by open fracture, vascular injury, soft-tissue loss and infection; the character of nerve injury was classified as 4-5 degree according to Sunderland Standard, nerve transfer is effective in the treatment of shotgun injuries of the sciatic nerve, but outcome is poor; the recovery of the sciatic nerve should be observed continually after injury; selecting correct initial treatment after injury, strict minimally invasive surgical procedure, physical therapy and reasonable preoperative and postoperative medication can improve the surgical results.
Department of Orthopaedic Surgery and Traumatology, Beijing Jishuitan Hospital, Medical School, Peking University, Beijing 100035, China.
Jun-qiang
JQ
Wang
Ming-jiang
MJ
Yi
Yin
Y
Zhu
Man-yi
MY
Wang
Bo-song
BS
Zhang
De-quan
DQ
Liu
Jie
J
Wei
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012584:Sciatic Nerve / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*