Missile injuries of the sciatic nerve

Missile injuries of the sciatic nerve are not common in civil practice. We analysed a war series of 55 cases operated on in a period from 1991 to 1995. Nerve continuity was preserved at least partially in 76.4% of cases, but only 13.3% of cases had preserved some nerve function. Surgical results were analysed in 45 cases followed for more than two years. The rates of useful functional recovery were 86.7% for tibial division, 53.3% for peroneal division and 86.7% for the sciatic nerve complex. On the basis of the obtained results we were able to make the following conclusions: (1) missile injuries to the sciatic nerve are characterised by partially preserved nerve continuity and complete functional loss in the majority of cases, (2) surgery should be performed 3 to 6 months after injury, (3) reconstruction of tibial division is the major goal of surgical repair, (4) the extent and severity of nerve damage and the type of surgical procedure are the main prognostic factors and (5) failures of surgical repair are usually related to nerve grafting at gluteal level.