Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(04): 773-777
DOI: 10.1055/s-0044-1787972
Case Report

Sciatic Nerve Entrapment from Cerclage Wiring in Intramedullary Nail Fixation

Mohsin Hussein 
1   Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Ankit Bipin Shah
2   Department of Radiology, Eclat Imaging Centre, Mumbai, Maharashtra, India
,
Bipin Ramanlal Shah
2   Department of Radiology, Eclat Imaging Centre, Mumbai, Maharashtra, India
,
Karthikeyan Parthasarathy Iyengar 
3   Department of Orthopedics, Mersey and West Lancashire Teaching Hospitals NHS Trust, United Kingdom
,
Rajesh Botchu
1   Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, United Kingdom
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Cerclage wiring may be used to optimize the stability of intramedullary nail or plate fixations in comminuted proximal femoral fractures, periprosthetic fractures, and other selected cases. In this article, we presented a novel case of iatrogenic sciatic nerve entrapment from cerclage wiring used to supplement intramedullary nail fixation. We also illustrate and highlight the role of ultrasound in assessing the sciatic nerve to make a timely diagnosis.

Keywords

sciatic nerve - entrapment - cerclage wiring - femoral neck fracture - intramedullary nail


Publication History

Article published online:
04 July 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Aleto T, Ritter MA, Berend ME. Case report: superficial femoral artery injury resulting from cerclage wiring during revision THA. Clin Orthop Relat Res 2008; 466 (03) 749-753
    CrossrefPubMedGoogle Scholar
  • 2 Mehta V, Finn HA. Femoral artery and vein injury after cerclage wiring of the femur: a case report. J Arthroplasty 2005; 20 (06) 811-814
    CrossrefPubMedGoogle Scholar
  • 3 Won Y, Yang KH, Kim KK, Weaver MJ, Allen EM. Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report. Arch Orthop Trauma Surg 2016; 136 (12) 1691-1694
    CrossrefPubMedGoogle Scholar
  • 4 Ehlinger M, Niglis L, Favreau H. et al. Vascular complication after percutaneous femoral cerclage wire. Orthop Traumatol Surg Res 2018; 104 (03) 377-381
    CrossrefPubMedGoogle Scholar
  • 5 Devendra A, Avinash M, Chidambaram D, Dheenadhayalan J, Rajasekaran S. Vascular injuries due to cerclage passer: relevant anatomy and note of caution. J Orthop Surg (Hong Kong) 2018; 26 (01) 2309499018762616
    CrossrefPubMedGoogle Scholar
  • 6 Nakamura Y, Tada K, Murai A, Tsuchiya H. Iatrogenic sciatic nerve injury due to cerclage wiring for proximal periprosthetic femoral fracture: a rare case report. JPRAS Open 2022; 32: 54-60
    CrossrefPubMedGoogle Scholar
  • 7 Mallory TH. Sciatic nerve entrapment secondary to trochanteric wiring following total hip arthroplasty. A case report. Clin Orthop Relat Res 1983; (180) 198-200
    Google Scholar
  • 8 Goderecci R, Fidanza A, Necozione S, Francione V, Indelli PF, Calvisi V. Ultrasound-based decision making following metal-on-metal hip arthroplasty. J Clin Orthop Trauma 2020; 11 (01) 79-84
    CrossrefPubMedGoogle Scholar
  • 9 Douis H, Dunlop DJ, Pearson AM, O'Hara JN, James SL. The role of ultrasound in the assessment of post-operative complications following hip arthroplasty. Skeletal Radiol 2012; 41 (09) 1035-1046
    CrossrefPubMedGoogle Scholar
  • 10 Kowalska B. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of posttraumatic neuropathies. J Ultrason 2015; 15 (60) 15-28
    CrossrefPubMedGoogle Scholar
  • 11 Guillin R, Botchu R, Bianchi S. Sonography of orthopedic hardware impingement of the extremities. J Ultrasound Med 2012; 31 (09) 1457-1463
    CrossrefPubMedGoogle Scholar
  • 12 Sidhu PS, Ewertsen C, Piskunowicz M. et al. Diversity of current ultrasound practice within and outside radiology departments with a vision for 20 years into the future: a position paper of the ESR ultrasound subcommittee. Insights Imaging 2023; 14 (01) 202
    CrossrefPubMedGoogle Scholar
  • 13 Cole B, Twibill K, Lam P, Hackett L, Murrell GA. Not all ultrasounds are created equal: general sonography versus musculoskeletal sonography in the detection of rotator cuff tears. Shoulder Elbow 2016; 8 (04) 250-257
    CrossrefPubMedGoogle Scholar
  • 14 Cornelson SM, Ruff AN, Wells C, Sclocco R, Kettner NW. Sonographic measures and sensory threshold of the normal sciatic nerve and hamstring muscles. J Ultrasound 2022; 25 (01) 47-57
    CrossrefPubMedGoogle Scholar
  • 15 Balius R, Pedret C, Iriarte I, Sáiz R, Cerezal L. Sonographic landmarks in hamstring muscles. Skeletal Radiol 2019; 48 (11) 1675-1683
    CrossrefPubMedGoogle Scholar
  • 16 Karmakar MK, Reina MA, Sivakumar RK, Areeruk P, Pakpirom J, Sala-Blanch X. Ultrasound-guided subparaneural popliteal sciatic nerve block: there is more to it than meets the eyes. Reg Anesth Pain Med 2021; 46 (03) 268-275
    CrossrefPubMedGoogle Scholar
  • 17 Shevlin S, Johnston D, Turbitt L. The sciatic nerve block. BJA Educ 2020; 20 (09) 312-320
    CrossrefPubMedGoogle Scholar
  • 18 Ojeda-Thies C, Sáez-López P, Currie CT. et al; participants in the RNFC. Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries. Osteoporos Int 2019; 30 (06) 1243-1254
    CrossrefPubMedGoogle Scholar
  • 19 Rehme J, Woltmann A, Brand A, von Rüden C. Does auxiliary cerclage wiring provide intrinsic stability in cephalomedullary nailing of trochanteric and subtrochanteric fractures?. Int Orthop 2021; 45 (05) 1329-1336
    CrossrefPubMedGoogle Scholar
  • 20 Kim JW, Park KC, Oh JK, Oh CW, Yoon YC, Chang HW. Percutaneous cerclage wiring followed by intramedullary nailing for subtrochanteric femoral fractures: a technical note with clinical results. Arch Orthop Trauma Surg 2014; 134 (09) 1227-1235
    CrossrefPubMedGoogle Scholar
  • 21 Dennis MG, Simon JA, Kummer FJ, Koval KJ, DiCesare PE. Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques. J Arthroplasty 2000; 15 (04) 523-528
    CrossrefPubMedGoogle Scholar
  • 22 Unnanuntana A, Saiyudthong N. Outcomes of cerclage wiring to manage intra-operative femoral fracture occurring during cementless hemiarthroplasty in older patients with femoral neck fractures. Int Orthop 2019; 43 (11) 2637-2647
    CrossrefPubMedGoogle Scholar
  • 23 Flug JA, Burge A, Melisaratos D, Miller TT, Carrino JA. Post-operative extra-spinal etiologies of sciatic nerve impingement. Skeletal Radiol 2018; 47 (07) 913-921
    CrossrefPubMedGoogle Scholar
  • 24 Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg 2004; 101 (01) 8-17
    CrossrefPubMedGoogle Scholar
  • 25 Jones PE, Meyer RM, Faillace WJ. et al. Combat injury of the sciatic nerve - an institutional experience. Mil Med 2018; 183 (9–10): e434-e441
    CrossrefPubMedGoogle Scholar
  • 26 Tufan A. Late results of early end-to-end repair in sciatic nerve injuries. Cureus 2023; 15 (10) e47101
    Google Scholar
  • 27 Maripuu A, Björkman A, Björkman-Burtscher IM, Mannfolk P, Andersson G, Dahlin LB. Reconstruction of sciatic nerve after traumatic injury in humans - factors influencing outcome as related to neurobiological knowledge from animal research. J Brachial Plex Peripher Nerve Inj 2012; 7 (01) 7
    PubMedGoogle Scholar
  • 28 Grinsell D, Keating CP. Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. BioMed Res Int 2014; 2014: 698256
    CrossrefPubMedGoogle Scholar