Surgery for sciatic nerve injuries

PURPOSE OF THE STUDY Injury to the sciatic nerve is a rare event. Apart from war time surgery, it usually presents as a closed lesion caused by traction. The aim of the study was to evaluate a group of patients treated for sciatic nerve injury, with an analysis of the cause for and the outcome of surgery. MATERIAL AND METHODS In this prospective study, the results in ten patients treated surgically were evaluated. Five patients underwent exoneurolysis, two were treated by end-to-end suture of the nerve and three by suture and sural nerve grafting. One patient was lost to follow-up and nine were followed up for minimally 24 months after surgery. RESULTS In the patients treated by exoneurolysis, sciatic nerve function recovered in the peroneal division in 60%, and in the tibial portion in 100% of them. The result depended mainly on the interval between injury and surgery. Of four patients with direct suture of the nerve or with sural nerve grafting, function of the tibial portion recovered in three (75%) and that of the peroneal portion in one (25%). CONCLUSIONS Although the course of the sciatic nerve is very long, its surgical treatment is fully justified because it shows good results even in buttock-level and thigh-level nerve injuries.