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Casestudies  >  Complex Fractures  >  Compound Fracture with Sciatic Nerve palsy due to gunshot wounds

 
Complex Fractures
 
 

high energy gunshot wound with displaced compound subtrochanteric fracture presented after 6 weeks with a large wound over the rear of the thigh. 35 year old farmer presented with a compound subtrochanteric fracture with a large unhealthy wound over the posterior upper part of the thigh. There were multiple pellets and a widely displaced fracture and a complete sciatic nerve palsy with loss of sensation over the foot and no movements of the foot.

Taylor's Spatial Frame fixator was applied for gradual reduction of fracture and to allow the patient to walk  and permit care of the wound with multiple debridements. The fracture was fixed and the patient allowed to walk with the help of the Taylor's Spatial Frame fixator. The fixator helped in gradual reduction of the fracture and mobilization as well as the wound care.

nerolysis of Sciatic nerve being performed with the Taylor's Spatial Frame fixator in situ after wounds had healed. When the large posterior wound over the thigh was healed in 6 weeks, we performed a neurolysis with the fixator in situ. The patient was positioned prone and a longitudinal incision was taken and the sciatic nerve was freed from dense fibrous tissue and complete neurolysis was successfully performed.

                            wounds and fracture have healed and the sciatic nerve is completely recovered its function in 6 months.                                    post-operative x-ray showing good healing of subtrochanteric fracture wih a very mild mount of acceptable angulation.

The fracture healed in 20 weeks with very mild angulation. The sciatic nerve started recovery in 12 weeks and recovered completely in 6 months. The wounds also healed and the patient did well.