Stavrakakis, I.M., Kritsotakis, E.I. orcid.org/0000-0002-9526-3852, Giannoudis, P.V. et al. (4 more authors) (2022) Sciatic nerve injury after acetabular fractures: a meta-analysis of incidence and outcomes. European Journal of Trauma and Emergency Surgery, 48 (4). pp. 2639-2654. ISSN 1863-9933
Abstract
Purpose: To investigate the incidence and the outcome of post-traumatic and iatrogenic sciatic nerve palsy (SNP) associated with fractures of the acetabulum. The results of sciatic nerve grafting for treatment were also investigated. Methods: PUBMED, SCOPUS and COCHRANE databases were searched for longitudinal observational studies reporting sciatic nerve palsy related to acetabular fractures in adult patients over the last 20 years. Data regarding patients demographics, type of acetabular fracture, rate of post traumatic and iatrogenic sciatic nerve palsies as well as recovery rate are reported. Studies were assessed for their quality. Random effects meta-analyses were carried out to pool overall proportions of SNP incidence and complete recovery. Variations in SNP incidence by main study characteristics were assessed by subgroup analysis and meta-regression. A narrative review of sciatic nerve grafting was also conducted. Results: Twenty studies reporting 44 post-operative and 18 iatrogenic SNPs in 651 patients were reviewed. The pooled incidence of posttraumatic SNP was 5.1% (95% CI 2.7–8.2%). The pooled incidence of iatrogenic SNP was 1.4% (95% CI 0.3–2.9%). Complete recovery of post-traumatic and iatrogenic SNP occurred in 64.7% (95% CI 41.7–85.4%) and 74.1% (95% CI 31.5–100%), respectively. Conclusion: A favorable outcome of both post-traumatic and iatrogenic SNP related to acetabular fractures has been found. Due to the poor results of sciatic nerve grafting, a "wait and see" approach may be the best option, in cases of a contused but anatomically intact sciatic nerve.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s), under exclusive licence to Springer-Verlag GmbH Germany |
Keywords: | acetabular fracture; acetabular fracture complications; sciatic nerve injury; sciatic nerve palsy; Acetabulum; Adult; Fracture Fixation, Internal; Fractures, Bone; Hip Fractures; Humans; Iatrogenic Disease; Incidence; Retrospective Studies; Sciatic Nerve; Sciatic Neuropathy; Spinal Fractures; Treatment Outcome |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 10 Aug 2023 09:10 |
Last Modified: | 10 Aug 2023 09:10 |
Status: | Published |
Publisher: | Springer Science and Business Media LLC |
Refereed: | Yes |
Identification Number: | 10.1007/s00068-022-01896-0 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202298 |