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Case Reports
. 2021 Sep 6:35:100532.
doi: 10.1016/j.tcr.2021.100532. eCollection 2021 Oct.

Iatrogenic sciatic nerve injury secondary to clamp placement around the femoral neck during proximal femoral fracture intramedullary nailing

George D Chloros  1 , Vasileios P Giannoudis  1 , Peter V Giannoudis  1   2
Affiliations
Case Reports

Iatrogenic sciatic nerve injury secondary to clamp placement around the femoral neck during proximal femoral fracture intramedullary nailing

George D Chloros et al. Trauma Case Rep. .

Erratum in

Abstract

- 20-year-old male road-traffic accident - Sustained right acetabulum fracture, left proximal femur fracture, right patella fracture and pulmonary contusions - Had fixation within 4 days of his left proximal femur fracture and his right acetabulum:-Following fixation of his left femur fracture, developed symptoms of complete left sciatic nerve palsy.-At the time of surgery, a heygroves clamp around the neck of the femur was used to assist in the reduction of the fracture.-Subsequent exploration of the sciatic nerve showed several clamp indentations on it but fascicles in continuity. - Nerve conduction studies at 4 months post-operatively confirmed a high sciatic nerve injury. - The patient has still not recovered any function 1 year post-operatively.

Keywords: Clamp; Femoral fracture; Nerve palsy; Sciatic nerve.

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Conflict of interest statement

The authors have no conflicts of interest. No funds were obtained for doing this research.

Figures

Fig. 1
Fig. 1
Pre-operative AP Pelvic film and 3D-CT reconstructions showing the left proximal femoral fracture.
Fig. 2
Fig. 2
Post-traction intraoperative fluoroscopy demonstrating the need for open reduction.
Fig. 3
Fig. 3
AP and lateral radiographs showing reduction of the fracture using two heygroves clamps, on the proximal and distal fragments respectively. Note the heygroves clamp placed around the femoral neck.
Fig. 4
Fig. 4
Postoperative AP and lateral radiographs of the fixation.
Fig. 5
Fig. 5
Intraoperative images of the sciatic nerve exploration showing multiple indentations (white arrow) on the nerve from the clamp.
Fig. 6
Fig. 6
At 4 months, AP and lateral radiographs show radiological features of healing activity of the fracture.
Fig. 7
Fig. 7
At 1 year post-injury, there is no motor or sensory function recovery as demonstrated on the left side.
See this image and copyright information in PMC

References

    1. Britton J., Dunkerley D. Closed nailing of a femoral fracture followed by sciatic nerve palsy. J. Bone Joint Surg. Br. 1990;72(2):318. - PubMed
    1. Pedri T.G., Treme G.P. Sciatic nerve palsy after operative treatment of subtrochanteric femur fracture resulting from postoperative hematoma: a case report. UNM Orthop. Res. J. 2017;6(1)

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