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Late sciatic nerve axonotmesis following acetabular reconstruction plate
J Moreta1, X Foruria1, F Labayru1
1Servicio de Cirugía Ortopédica y Traumatología, Hospital Galdakao-Usansolo, Galdácano, Vizcaya, España.
Revista Espanola De Cirugia Ortopedica Y Traumatologia
|March 10, 2015
Summary
Delayed sciatic nerve injury after acetabular fracture repair is rare. A 17-year post-operative case revealed nerve transection due to screw impingement, highlighting a unique cause of long-term neurological deficit.
Area of Science:
- Orthopedic Surgery
- Neurology
- Trauma Care
Background:
- Acetabular fractures can lead to sciatic nerve injuries, typically occurring during trauma or surgery.
- Late-onset sciatic nerve issues post-acetabular fracture repair are uncommon, often linked to heterotopic ossification, scarring, or implant issues.
Observation:
- A patient with a prior transverse acetabular fracture, treated with posterior column reconstruction, developed progressive sciatic nerve symptoms 17 years later.
- Radiological and neurophysiological studies indicated nerve compression, leading to surgical intervention.
Findings:
- Surgical exploration revealed sciatic nerve transection caused by prolonged impingement from a reconstruction plate screw.
- Post-decompression, the patient experienced significant pain reduction and paresthesia resolution, but motor deficits persisted.
Implications:
- This case highlights an unusual etiology of delayed sciatic nerve injury: chronic hardware impingement years after acetabular fracture surgery.
- It underscores the importance of considering long-term hardware complications in the differential diagnosis of persistent or delayed neurological deficits in orthopedic trauma patients.
