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Post Thermal Sciatic Nerve Injury Successfully Repaired with a Sural Nerve Graft: Case Report

Received: 28 February 2019    Accepted: 8 July 2019    Published: 6 August 2019
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Abstract

Loss of the sciatic nerve may result in paralysis and sensory loss of the leg. Among indications for lower limb amputation is blunt trauma to the nerve that is feared to have no chances of recovery. Injuries of thermal in nature are thought to have an extensive damage far from the site of injury and are thus unlikely to recover. The injured nerve is likely to heal by fibrosis and scarring making it difficult for any axons to go through it. The only hope for such recovery is removal of all injured sections followed by the nerve repair with a nerve graft or nerve transfer. With advances in microsurgery more and more injured nerves that were otherwise considered unsalvageable are now routinely reconstructed with relatively good outcomes. A good proportion of this are nerve injuries of the upper limbs such brachial plexus, median, ulnar and radial nerve injuries. Compared to the upper limb nerve injuries there is little data on the outcomes of lower limb nerve injuries. The tendency towards amputation of the lower limb following blunt trauma to the sciatic nerve is much higher than the upper limb. We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes.

Published in Journal of Surgery (Volume 7, Issue 5)
DOI 10.11648/j.js.20190705.11
Page(s) 119-122
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sciatic Nerve Injury, Post Thermal, Repair

References
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[3] Georg Reith, Rolf Lefering, Arasch Wafaisade, Kai O. Hensel Injury pattern, outcome and characteristics of severely injured pedestrian Scand J Trauma Resusc Emerg Med. 2015; 23: 56. Published online 2015 Aug 5. doi: 10.1186/s13049-015-0137-8.
[4] Immerman I, Price AE, Alfonso I, Grossman JAI. Lower extremity nerve trauma. Bull Hosp Joint Dis. 2014; 72 (1): 43–52. Google Scholar.
[5] Shahid, K. R., Dellon, A. L., Amrami, K. K., & Spinner, R. J. (2015). Sciatic and peroneal nerve injuries after endovascular ablation of lower extremity varicosities: Case reports and review of the literature. Annals of Plastic Surgery, 74 (1), 64-68. https://doi.org/10.1097/SAP.0000000000000193.
[6] Aydin A1, Ozkan T, Aydin HU, Topalan M, Erer M, Ozkan S, The results of surgical repair of sciatic nerve injuries. Acta Orthop Traumatol Turc. 2010; 44 (1): 48-53. doi: 10.3944/AOTT. 2010.2172.
[7] Trumble TE1, Vanderhooft E, Khan U, Sural nerve grafting for lower extremity nerve injuries. J Orthop Trauma. 1995 Apr; 9 (2): 158-63.
[8] Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg. 2004; 7: 8–17. doi: 10.3171/jns. 2004.101.1.0008. [PubMed] [CrossRef.
[9] Korompilias AV1, Payatakes AH, Beris AE, Sciatic and peroneal nerve injuries Neurosurgery. 2009 Oct; 65 (4 Suppl): A18-23. doi: 10.1227/01. NEU. 0000339123.74649. BE.
[10] Amanda Maripuu, 1Anders Björkman, 1Isabella M Björkman-Burtscher Reconstruction of sciatic nerve after traumatic injury in humans - factors influencing outcome as related to neurobiological knowledge from animal researchJ Brachial Plex Peripher Nerve Inj. 2012; 7: 7. Published online 2012 Oct 10. doi: 10.1186/1749-7221-7-7 PMCID: PMC35400248.
[11] Kline DG, Kim D, Midha R, Harsh C, Tiel R. Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurg. 1998; 7: 13–23. doi: 10.3171/jns. 1998.89.1.0013. [PubMed] [Cross Ref].
[12] Vayvada H, Demirdöver C, Menderes A, Yilmaz M, Karaca C. The functional results of acute nerve grafting in traumatic sciatic nerve injuries. Turk J Trauma Emerg Surg. 2013; 19 (2): 109–14.15. Kim DH, Cho Y, Ryu S, Tiel RL, Kline DG. Surgical management and results of 135 tibial nerve lesions at the Louisiana State University health sciences center. Neurosurgery. 2003; 53: 1114–25. View ArticlePubMedGoogle Scholar.
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  • APA Style

    Nangole Wanjala Ferdinand, Ochieng Sephania Raduma. (2019). Post Thermal Sciatic Nerve Injury Successfully Repaired with a Sural Nerve Graft: Case Report. Journal of Surgery, 7(5), 119-122. https://doi.org/10.11648/j.js.20190705.11

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    ACS Style

    Nangole Wanjala Ferdinand; Ochieng Sephania Raduma. Post Thermal Sciatic Nerve Injury Successfully Repaired with a Sural Nerve Graft: Case Report. J. Surg. 2019, 7(5), 119-122. doi: 10.11648/j.js.20190705.11

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    AMA Style

    Nangole Wanjala Ferdinand, Ochieng Sephania Raduma. Post Thermal Sciatic Nerve Injury Successfully Repaired with a Sural Nerve Graft: Case Report. J Surg. 2019;7(5):119-122. doi: 10.11648/j.js.20190705.11

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  • @article{10.11648/j.js.20190705.11,
      author = {Nangole Wanjala Ferdinand and Ochieng Sephania Raduma},
      title = {Post Thermal Sciatic Nerve Injury Successfully Repaired with a Sural Nerve Graft: Case Report},
      journal = {Journal of Surgery},
      volume = {7},
      number = {5},
      pages = {119-122},
      doi = {10.11648/j.js.20190705.11},
      url = {https://doi.org/10.11648/j.js.20190705.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190705.11},
      abstract = {Loss of the sciatic nerve may result in paralysis and sensory loss of the leg. Among indications for lower limb amputation is blunt trauma to the nerve that is feared to have no chances of recovery. Injuries of thermal in nature are thought to have an extensive damage far from the site of injury and are thus unlikely to recover. The injured nerve is likely to heal by fibrosis and scarring making it difficult for any axons to go through it. The only hope for such recovery is removal of all injured sections followed by the nerve repair with a nerve graft or nerve transfer. With advances in microsurgery more and more injured nerves that were otherwise considered unsalvageable are now routinely reconstructed with relatively good outcomes. A good proportion of this are nerve injuries of the upper limbs such brachial plexus, median, ulnar and radial nerve injuries. Compared to the upper limb nerve injuries there is little data on the outcomes of lower limb nerve injuries. The tendency towards amputation of the lower limb following blunt trauma to the sciatic nerve is much higher than the upper limb. We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes.},
     year = {2019}
    }
    

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    AU  - Nangole Wanjala Ferdinand
    AU  - Ochieng Sephania Raduma
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    N1  - https://doi.org/10.11648/j.js.20190705.11
    DO  - 10.11648/j.js.20190705.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
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    EP  - 122
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20190705.11
    AB  - Loss of the sciatic nerve may result in paralysis and sensory loss of the leg. Among indications for lower limb amputation is blunt trauma to the nerve that is feared to have no chances of recovery. Injuries of thermal in nature are thought to have an extensive damage far from the site of injury and are thus unlikely to recover. The injured nerve is likely to heal by fibrosis and scarring making it difficult for any axons to go through it. The only hope for such recovery is removal of all injured sections followed by the nerve repair with a nerve graft or nerve transfer. With advances in microsurgery more and more injured nerves that were otherwise considered unsalvageable are now routinely reconstructed with relatively good outcomes. A good proportion of this are nerve injuries of the upper limbs such brachial plexus, median, ulnar and radial nerve injuries. Compared to the upper limb nerve injuries there is little data on the outcomes of lower limb nerve injuries. The tendency towards amputation of the lower limb following blunt trauma to the sciatic nerve is much higher than the upper limb. We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes.
    VL  - 7
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Author Information
  • Department of Surgery, University of Nairobi, Nairobi, Kenya

  • Defense Forces Memorial Hospital, Nairobi, Kenya

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