Sciatic and femoral nerve injury among patients who received Bernese peri-acetabular osteotomy

To investigate the incidence, risk factors, and the last follow-up recovery status of sciatic and femoral nerve injury among patients who received Bernese peri-acetabular osteotomy (PAO).

The clinical file of 643 consecutive patients who received PAO from June 2012 to June 2016 was retrospectively reviewed. The number of nerve injury patients was calculated and the causes of injury were recorded.

The sciatic or femoral nerve injury occurred in eight patients (1.24%), including four sciatic nerve injuries and four femoral nerve injuries. The reasons for sciatic nerve injury included one direct sciatic nerve injury happened at the time when deep osteotomy penetrated the posterior column to cut the nerve trunk at the area where the nerve runs through out of the greater sciatic foramen during quadrilateral bone osteotomy. The other two direct sciatic nerve injuries occurred at the inside pelvis by long drill bit or Kirschner wire drilling before the transverse screw fixation. No direct injury reasons could be found for the remaining five patients with one partial sciatic nerve injury and four femoral nerve palsies. The three patients with direct sciatic nerve injuries were partly recovered at the last follow-up. Full recovery was found in one sciatic nerve injury and four femoral nerve injury patients.

The sciatic nerve can be injured directly or indirectly during PAO. It is of great importance to understand the risk factors and the precautionary measures of nerve injuries during PAO.