Analysis of Penetrating Injuries to the Sciatic Nerve, Highlighting Insights From Sudan.

Background: Sciatic nerves extend a considerable distance through the thigh and are near bone, which increases their risk of injury. This vulnerability can result in long-lasting morbidity and disability. Injuries caused by high-energy weapons can affect neural tissue through multiple pathways, and the effectiveness of subsequent interventions is often unpredictable.

Methods: This is a descriptive retrospective analysis of a multicenter, cross-sectional hospital-based study focused on the evaluation and reconstruction of sciatic nerve injuries in Sudan from January 2022 to January 2024. The study encompassed all patients who had sciatic nerve injuries due to penetrating mechanisms and subsequently received reconstructive surgery. Patients with severe injuries leading to death and those with traumatic limb amputations have been excluded from the analysis.

Results: Among the 34 patients studied, a significant majority, 85.3%, were men, whereas women constituted 14.7%. The highest representation was the 20- to 30-year-old group, which accounts for 50%. The primary cause of the injuries was gunshot wounds. Sciatic nerve injuries were associated with femoral fractures in 26.5%. The predominant surgical approach used was neurolysis (41.2%), with primary repair (35.3%) and nerve graft repair (23.5%). Deep sensation was restored within 6 months following surgery, except in 2.9% who did not recover sensation.

Conclusions: The sciatic nerve is frequently injured due to penetrating wounds in the lower limbs, leading to potentially severe disabilities. Although surgical options can be beneficial, particularly for sensory restoration and managing neuropathic pain, it is vital to engage in rehabilitation as muscle recovery progresses.