پيش آگهي ضايعات عصب سياتيك همراه با شكستگي هاي استابولوم

Prognosis of the Sciatic Nerve Lesion Associated with Acetabular Fractures

Background: Sciatic nerve lesion associated with acetabular fractures is observed in 10% of cases. In the present study our experience in a small group of such an injury is reported. Methods: During a 5-year period (1996-2001) out of 145 patients with acetabular fracture, 18 cases of sciatic nerve injury with 3-year average follow-up (30-41 months) were studied. The severity of injury for each division of the nerve was determined by the use of Medical Research Council Scale in each patient on the first day of admission. In two patients the nerve injury was iatrogenic. Assessment of neurological recovery and functional results was done with the use of Clawson & Seddon rating system. At the latest follow-up evaluation, recovery of the nerve and functional outcome was rated as either satisfactory or unsatisfactory. Statistical analyses of the data were done using Chi- square and Fisherʹs Exact Tests. Results: 45% of the patients had satisfactory neurological recovery; and 78% had satisfactory functional outcome. The patients with an isolated mild involvement of the peroneal nerve, had a favorable prognosis, but those who had a severe injury of the peroneal nerve, whether it was isolated or associated with the injury of the tibial component, did not have satisfactory recovery. Conclusion: The prognosis of sciatic nerve lesion associated with acetabular fracture is satisfactory in terms of functional outcome. Neurological recovery is poor for the peroneal component