Sciatic neuropathy - orthopedic hardware induced

Case contributed by Dr Maulik S Patel

Presentation

History of two prior surgeries for left femur fracture fixation. Clinically she developed sciatic neuropathy. Nerve conduction test revealed severe compression of the sciatic nerve in the thigh region. Ultrasound was requested for sciatic nerve tracing.

Patient Data

Age: 35 years
Gender: Female

The sciatic nerve shows continuity. The nerve is anteriorly displaced at the femur shaft fracture site. There are two cerclage wires around the femur at this level. There is a reverberation artifact due to wires. The cranial wire is passing through the sciatic nerve and causing anterior nerve traction. About 30 mm long nerve segment at this level is thickened, hypoechoic. The caudal wire is between the femur cortex and the sciatic nerve. There is no local collection or mass lesion.

Case Discussion

Findings favor orthopedic hardware induced sciatic neuropathy.

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