Background: Sciatic neuropathy associated with acetabular fractures
can result in disabling long-term symptoms. The purpose of this retrospective
study was to evaluate the effect of sciatic nerve release on sciatic
neuropathy associated with acetabular fractures and reconstructive acetabular
Methods: Between 2000 and 2004, ten patients with sciatic neuropathy
associated with an acetabular fracture were treated with release of the
sciatic nerve from scar tissue and heterotopic bone. Additional surgical
procedures included open reduction and internal fixation of the acetabulum
(five patients), removal of hardware and total hip arthroplasty (three
patients), and removal of hardware alone (one patient). The average age of the
patients was forty-three years. All patients were followed with serial
examinations and assessments for a minimum of one year (average, twenty-six
Results: All patients had partial to complete relief of radicular
pain, of diminished sensation, and of paresthesias after the nerve release.
Four of seven patients with motor loss and two of five patients with a
footdrop demonstrated improvement in function after the nerve release. No
patient had evidence of worsening on neurologic examination after the
Conclusions: Sciatic nerve release during reconstructive acetabular
surgery can decrease the sensory symptoms of preoperative sciatic neuropathy
associated with a previous acetabular fracture. Motor symptoms, however, are
less likely to resolve following nerve release.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.