Sciatic nerve laceration associated with closed femoral shaft fracture: A case report

Abstract

Sciatic nerve laceration is rarely found in closed femoral shaft fractures. We report a case where a 20-year-old motorcyclist sustained a closed femoral shaft fracture associated with sciatic nerve palsy. The sciatic nerve was explored 8 months after the injury when no neurological recovery was noted. The common peroneal division of the sciatic nerve was found to be disrupted and the posterior tibial division stretched at the bifurcation. Sural nerve graft was performed. Sensory recovery was noted but the foot drop remained, for which tibialis posterior tendon transfer was done one year after the nerve grafting. The patient achieved full dorsiflexion of his ankle with no sensory deficit. It is important to exclude sciatic nerve damage in all femoral fractures. Nerve exploration is warranted if no recovery is reported after 6 to 8 months of observation. Multiple procedures may be needed to achieve full functional recovery.