Evidence map›Paper›PMID 39990702›Full record

ArticleNeurotrauma reports2025

Profound Neuropathy after Penetrating Transection of the Sciatic Nerve by Femoral Cerclage Wire: Illustrative Case and Management Strategy.

John K Yue, Jun Yeop Oh, Alexander A Aabedi, Jia-Shu Chen, Kenneth X Probst, Vinil N Shah, Rosanna L Wustrack, Line G Jacques

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In one paragraph

Article in Neurotrauma reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

John K YueDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-9694-7722
Jun Yeop OhDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Alexander A AabediDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Jia-Shu ChenDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Kenneth X ProbstDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Vinil N ShahDepartment of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
Rosanna L WustrackDepartment of Orthopedic Surgery, University of California, San Francisco, San Francisco, California, USA.
Line G JacquesDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sciatic nerve injury associated with total hip arthroplasty (THA) confers chronic and progressive disability. Mechanisms of injury are heterogeneous and management nuances are often case-specific. We discuss a Sunderland Type 4 sciatic nerve transection by femoral cerclage wire from prior THA to highlight optimal clinical strategies when approaching complex cases. A 65-year-old woman presented to the neurosurgery clinic with worsening, medically refractory right sciatic sensorimotor neuropathy that began 1 year after ipsilateral hip arthroplasty. Neurological examination detected weakness in ankle dorsiflexion/plantarflexion and foot inversion/eversion (motor scale 2-3/5), toe extension/flexion (1/5), foot numbness, and hyperesthesia. Electromyogram confirmed sciatic neuropathy. Magnetic resonance neurogram (MRN) showed a thickened right sciatic nerve abutting a femoral cerclage wire, which appeared contiguous on reconstructed computed tomography imaging. Intraoperatively, the wire was discovered to have clearly transected and remained lodged within the sciatic nerve, requiring orthopedic surgery consultation and wire cutdown at the transection site. The surrounding neuroma was excised and the defect was reconstructed using nerve allograft interposition. Intraoperative neurophysiology monitoring (IONM) signals remained stable. Radiographs confirmed uncomplicated wire disconnection. The patient was discharged home the next day and reported significant symptomatic relief at 1-month follow-up. Delayed presentation of sciatic nerve transection by femoral cerclage wire with ongoing neural compression is rare. The anatomy of injury can be high risk, impelling thoughtful operative planning in THA as well as neuroplasty cases. Strategies include preoperative MRN to evaluate the pathoanatomy of nerve injury, neurosurgery and orthopedic surgery comanagement, and multimodal IONM to reduce risks of intraoperative neural injury and optimize outcomes.

Indexed as

clinical decision-makingintraoperative neurophysiological monitoringneuroimagingsciatic neuropathysurgical diagnostic techniquetotal hip arthroplasty

Identifiers

PMID39990702
PMCPMC11839513

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