Complete Sciatic Nerve Transection Associated with a Closed Femoral Shaft Fracture

Femoral shaft fractures are usually the result of a high-energy injuries. It is estimated that annually between 1.0 and 2.9 million femoral shaft fractures occur worldwide. In high-income countries the annual incidence of femoral shaft fractures ranges between 8.2 and 23.9 per 100,000 people.

Due to the high-energy mechanism, associated injuries are common in this patient population and the inhospital mortality has been reported to be approximately 1.4%. In particular, musculoskeletal injuries to the ipsilateral limb, such as hip fractures, patella fractures, tibial plateau fractures, and ligamentous knee injuries have been reported to commonly occur in conjunction with high-energy femoral shaft fracture.

However, reports on peripheral nerve injuries as a result of a femoral shaft fracture are limited in the orthopaedic literature. Rodriguez-Merchan et al. reported on 150 femoral shaft fractures and observed temporary neurologic deficits in 10 patients. A few case reports have reported on injuries to the sciatic nerve associated with femoral shaft fractures.

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