What Are the Different Types of Sciatic Nerve Damage?
The sciatic nerve consists of L4, 5 and S1, 2, 3 nerve roots. The cause of the injury is mostly caused by firearm injuries to the thigh or hip. Sometimes hip joint dislocation and pelvic fracture can also be combined with sciatic nerve injury.
- English name
- Sciatic Nerve Injury
- Visiting department
- orthopedics
- Common locations
- Sciatic nerve
- Common causes
- Posterior hip dislocation, hip stab wounds, hip contracture surgery injuries, and hip injections
- Common symptoms
- Muscle paralysis, inability to flex knees, complete loss of ankle and toe motor function, sagging feet, etc.
Basic Information
Causes of sciatic nerve injury
- Posterior dislocation of the hip joint, hip injury, hip contracture surgery injury, and injection of hip muscles can all cause high injuries.
Clinical manifestations of sciatic nerve injury
- Posterior dislocation of the hip joint, hip stab wounds, gluteal muscle contracture surgery injuries, and injection of hip muscles can all cause high injuries, causing paralysis of the posterior femoral muscles and all muscles of the calves and feet, resulting in inflexible knee joints, ankle joints and Toe motor function is completely lost, and the foot is drooping. Sensory loss of the posterolateral calf and feet, and neurotrophic changes in the feet. Because the quadriceps is healthy, the knee joint is in a straight state, and there is a gait when walking. If the middle and lower part of the posterior femur is injured, the posterior femoral muscles are normal and the knee flexion function is preserved.
Examination of sciatic nerve injury
- Electrophysiological examination: Typical neuroelectrophysiological manifestations include slowed nerve conduction velocity on the affected side, decreased amplitude, and prolonged F wave or H reflex latency; prolonged latency of somatosensory evoked potential, decreased amplitude, and prolonged wave interval; electromyography of sciatic nerve innervating muscles Examinations were mostly denervated and the healthy side was normal. The electromyogram of the quadriceps on the affected side was mostly abnormal, and the slightly stronger knee tendon reflex was also related to the normal function of the muscle and the weakening of the antagonistic muscle function. These manifestations help distinguish Guillain-Barre syndrome and polio.
Diagnosis of sciatic nerve injury
- History of trauma or injection, paralysis of muscles below the thigh or below the knee; muscle paralysis in the innervation zone of the nerve branch, partial loss of sensation in the area below the calf, and EMG examination can confirm the diagnosis.
Treatment of sciatic nerve injury
- Hip sciatic nerve injury is one of the most difficult and least effective injuries in peripheral nerve injury. The damage of each segment is closely related to the local anatomy. Drug injection injury should strive for nerve release as soon as possible, repeated washing with normal saline, and postoperative use of hyperbaric oxygen therapy can effectively promote regeneration and repair of the injured sciatic nerve. The younger the patient, the earlier the operation, the better the effect; such as cutting injuries Device injuries should be repaired in one stage. Adventitia-to-end anastomosis should be performed. Postoperative fixation should be performed at the hip extension and knee flexion position for 6 to 8 weeks. For hip injury or pelvic fracture caused by sciatic nerve injury, reduction and decompression should be performed early. Compression, observe 1 to 3 months and then decide whether to explore the nerve according to the recovery; if it is a firearm injury, only debridement is performed in the early stage, and exploration and repair should be performed 3 to 4 weeks after the wound heals. Late foot and ankle function reconstruction can improve limb function.