Sciatic Nerve Injury

INTRODUCTION:

arises from lumbosacral plexus: L4, L5, S1, S2, S3;

nerve emerges from pelvis below piriformis & enters thigh between ischial tuberosity &  greater trochanter;

in 10% of patients, the sciatic nerve is separated in greater sciatic foramen by all or part of the piriformis;

sciatic nerve is accompanied by PFCN & by inferior gluteal artery and its special branch to nerve;

nerve enters thigh beneath lower border of maximus;

descends near middle of thigh, lying on adductor magnus muscle & being crossed obliquely by long head of biceps femoris ;

nerve usually separates in upper part of popliteal space;

Tibial Nerve Branch:

from anterior branches of LS plexus: L4, L5, S1, S2, S3;

2 branches from tibial division: below quadratus femoris:

upper branch passes to long head of biceps femoris & upper portion ofsemitendinosus;

lower branch: innervates lower portion of  semitendinosus & semimembranous  & ischiocondylar portion of  adductor magnus ;

Common Peroneal Nerve:

from posterior branches: L4, L5, S1, S2;

nerve to short head of L4, L5, S1, S2 arises from lateral side of sciatic nerve (common peroneal portion)

in middle of thigh & enters superficial surface of the muscle;

Causes for sciatic nerve injury:

in Total hip replacement(THR) the sciatic nerve may be injured by excessive tension when extremity has been lengthened significantly

sciatic nerve is at risk during leg lengthening;

peroneal division is most often affected;

with sciatic nerve injury following THR, keep patients leg flexed over side of bed;

if injury was due to traction, the nerve may recover in the relaxed position;
Sciatic Nerve Injury treatment
sciatic nerve palsy from Kocher Langenbock Approach;

can be prevented by intra-p monitoring of amount of tension applied by assistants retracting the nerve;

early treatment consists of ANKLE FOOT ORTHOSIS

sciatic nerve recovery may occur over a 3 yr period;

tendon transfers are usually not performed unitl 3 yr post op;

PHYSIOLINE’S SPECIALISED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

Relief pain

Restore strength

Muscle reeducation

Restore sensation

Prescription of orthoses

 

Visit Physioline for the Consultation and treatment