Surgical Repair of Sciatic Nerve and its Branch Injuries in Libyan War Casualties

Abstract Background: The sciatic nerve consists of two distinct di-visions: Tibial and peroneal. Injuries to the sciatic nerve dur-ing combat are often severe, resulting in varying but generally major effects. These injuries are sometimes accompanied by extensive damage to soft tissues and bones, substantial neu-rological impairment, intense neuropathic pain, and a lengthy healing period. Aim of Study: This retrospective study aimed to assess the outcomes of surgical treatment of sciatic nerve injuries in indi-viduals who were injured during the Libyan war. Patients and Methods: During the Libyan War from 2017 to 2019, we utilized nerve grafting, direct end-to-end coapta-tion, and neurolysis to treat 19 patients with sciatic nerve injury. Gunshot wounds affecting the upper thigh or pelvis were the most common causes of injury. Results: Of the total number of patients, 75% experienced injury to the tibial nerve, whereas 85% experienced injury to the common peroneal nerve. 67% of those with upper-third le-sions had excellent recovery of protective feeling in the sole. For the tibial nerve, the total percentage of motor recovery was 85%, and for the common peroneal nerve, it was 35%. Conclusion: The outcomes of treating sciatic nerve dam-age in these patients with war-related injuries were largely fa-vorable. Repairing tibial nerve damage in the upper thigh has a greater chance of recovery compared to the common peroneal nerve. Tendon transfer or orthopedic devices can effectively address motor impairments caused by damage to the common peroneal nerve.