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Case Reports: Reminder of important clinical lesson
Complete transection of the sciatic nerve following closed femoral fracture
  1. Emma Johnston1,
  2. Kevin McGarry2,
  3. Serena Martin2 and
  4. Harry Lewis2
  1. 1School of Medicine, Queen's University Belfast, Belfast, UK
  2. 2Department of Plastic and Reconstructive Surgery, South Eastern Health and Social Care Trust, Belfast, Dundonald, UK
  1. Correspondence to Emma Johnston; ejohnston52{at}qub.ac.uk

Abstract

Complete transection of the sciatic nerve following femoral fracture is extremely rare. In the setting of closed injury it has only been reported in two other cases. Here we present a teenage motorcyclist who sustained a closed left, mid-femoral fracture following a road traffic collision with complete transection of the sciatic nerve. Despite being a closed injury, the obvious limb deformity of the patient and extreme pain prompted immediate nerve block during the primary survey making formal neurological assessment difficult. This case highlights the possibility of complete major nerve transection in closed injuries, and the importance of careful clinical examination alongside repeat imaging.

  • Orthopaedic and trauma surgery
  • Plastic and reconstructive surgery
  • Trauma CNS /PNS

https://doi.org/10.1136/bcr-2021-247765

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    Footnotes

    • Twitter @ejohnston52

    • Contributors EJ, KM, SM, HL devised the project, the main conceptual idea and outlined direction. EJ wrote the initial manuscript and formatted for submission. KM, SM, HL made revisions and enhanced the discussion. EJ, KM, SM, HL gained consent from the patient at clinic. KM, SM, HL supervised the project.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.