A Taha1, J Taha. 1. Department of Surgery, American University of Beirut Medical Center, Lebanon.
Abstract
OBJECTIVE: To evaluate functional recovery after suture of the sciatic nerve after missile injury. METHODS: We reviewed the outcome of 23 adults and four children who had the sciatic nerve sutured above the knee 3 to 14 weeks after missile injury and who were followed for 14 to 36 months. RESULTS: In adults, useful motor recovery was significantly better after suture of tibial (83%) than peroneal (39%) nerves, after suture of nerves at the thigh (71%) than at the buttock (31%) level, and after end-to-end anastomosis (74%) than grafting (39%). Useful sensory function was recovered in 78% of tibial nerves. Fifty-seven percent of adults walked wearing special shoes or pads. Significantly better recovery occurred in children, who all walked with normal footwear. CONCLUSION: We advocate exploration of the sciatic nerve at any level within 3 months if no spontaneous recovery occurs after a missile injury. We do not advocate exploration of the sciatic nerve at the buttock level if only peroneal function is lost except in children.
OBJECTIVE: To evaluate functional recovery after suture of the sciatic nerve after missile injury. METHODS: We reviewed the outcome of 23 adults and four children who had the sciatic nerve sutured above the knee 3 to 14 weeks after missile injury and who were followed for 14 to 36 months. RESULTS: In adults, useful motor recovery was significantly better after suture of tibial (83%) than peroneal (39%) nerves, after suture of nerves at the thigh (71%) than at the buttock (31%) level, and after end-to-end anastomosis (74%) than grafting (39%). Useful sensory function was recovered in 78% of tibial nerves. Fifty-seven percent of adults walked wearing special shoes or pads. Significantly better recovery occurred in children, who all walked with normal footwear. CONCLUSION: We advocate exploration of the sciatic nerve at any level within 3 months if no spontaneous recovery occurs after a missile injury. We do not advocate exploration of the sciatic nerve at the buttock level if only peroneal function is lost except in children.
Authors: Unai García de Cortázar; Sabino Padilla; Enrique Lobato; Diego Delgado; Mikel Sánchez Journal: J Clin Med Date: 2018-01-29 Impact factor: 4.241