Sciatic Nerve Injury


Supply

Motor supply


Tibial Component

 Hamstrings , Gastocnemius , Posterior Tibialis , Long Flexor of Toes

Peroneal Component

 Anterior Tibialis , Long Extensor of Toes (deep peroneal nerve )

 Sensory supply

   Via Sural Nerve , Deep Fibular Nerve , Superficial Fibular Nerve , Medial Calcaneal Branches


Affects in

 Knee Flexion

 Ankle - Flexion / Extension

 Toe flexion / Extension

 Sensation - Loss

 Due to peroneal Divsion

         lateral aspect of leg , dorsum of foot

 Due to Tibial Division

          plantar aspect of foot



 Late deformities

 Equinus Deformity , Clawing of Toes , Atrophy of muscles supplied by this nerve.



Investigations

 EMG  for the Nerve

Investigation of the injury  - X-ray of the bone and joint to find out the cause.

                                       


Treatment

 Release comrpessing Leg cast



Endoneuroloysis for prolonged compression



Explore for fracture and dislocation of hip, shaft of femur fracture , knee dislocation early

            when no signs of recovery seen and if any chances of repair.



Penetrating Injuries on buttock -early exploration and repair


Methods of Closing gaps

  Knee flexion  , hip hyperextended - this method closes gap upto 15 cm

  resect part of femur.



Post operatively - Double spica cast

 6 weeks cast off , long leg brace with adjustable knee brace and gradually extend knee.


 ROM Exercises


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