Late sciatic nerve entrapment following pelvic plate reconstruction in total hip arthroplasty

Delayed sciatic neuropathy due to pelvic reconstruction plate loosening following complex acetabular reconstruction in total hip arthroplasty seems not be have been previously reported. We identified a 79-year-old woman who developed progressive neurologic signs of entrapment 6 months following reconstruction of a pelvic discontinuity due to fracture nonunion caused by radiation necrosis. Magnetic resonance imaging of the lumbar spine was unrevealing and electromyography demonstrated a peripheral neurogenic process involving the sciatic nerve. Sciatic nerve exploration was done at 12 months after surgery finding a loose screw in the pelvic plate impinging the nerve. Substantial improvement in clinical symptoms resulted from removal and nerve release.