Hip and pelvic fractures and sciatic nerve injury

To investigate the influence of hip a nd pelvic fracture, especially acetabular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury. Methods: From January 1987 to January 2000, 17 patients (14 mal e and 3 female) who had hip and pelvic fractures complicated by sciatic nerve in jury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years. The average age was 38 years (ranging 23 56 years). The left extremities were involved in 11 patients and the right in 6. Twelve pa tients underwent primary exploration and neurolysis and 5 patients underwent sec ondary operation. Results: Preoperatively, 8 patients were treated with large dos es of oral narcotics to control their severe sciatic pain. Three of the 8 patien ts underwent patient controlled analgesia and epidural analgesia. After operati on, excellent and good rates of reduction and functional recovery of sciatic ner ve were 94.1 % and 88% respectively. Four patients still had sciatic pain and 2 patients failed to recover. Sciatic nerve function improved within 3 6 month s after surgery in 11 patients. Conclusions: Hip and pelvic fractures can result in sciatic ner ve injury, especially common peroneal nerve injury and prognosis is poor. Open r eduction and internal fixation combined with nerve exploration and neurolysis sh ould be used as early as possible for severe sciatic pain.