Frequency and Prognostic Evaluation of Sciatic Nerve Injury following Posterior Wall Acetabular Fixation

Abstract

Objective:  To evaluate the frequency of sciatic nerve injury after surgical fixation of posterior wall acetabular fractures and to assess its impact on neurological recovery and functional outcome.

Materials & Methods:  A prospective observational study was conducted at the Department of Orthopedics Lady Reading Hospital Peshawar from April 2024 to May 2025 A total of 110 patients who underwent posterior wall acetabular fixation were included Sciatic nerve function was assessed before and after surgery using clinical and electrophysiological methods Follow-up evaluations were done at one three and six months Functional outcomes were measured using the Medical Research Council scale and the Lower Extremity Functional Scale.

Results:  Sciatic nerve injury occurred in 16 patients, which is 14.5 percent. The peroneal division was affected more than the tibial division. Most injuries were neuropraxia, with 81.3 percent of these cases showing favorable recovery within six months. Poor outcomes were linked to surgery delayed beyond seven days, intraoperative traction lasting more than thirty minutes, and complex fracture patterns.

Conclusion:  Sciatic nerve injury is a significant complication following posterior wall acetabular fixation. However, most cases recover without major intervention. Early surgery, minimal traction, and careful handling of fracture fragments can reduce injury risk and improve functional recovery.