Systematic Review and Meta-Analysis of Sciatic Nerve Injury in Acetabular Fractures

Abstract

Background: Acetabular fracture is a challenging orthopaedic injury, usually associated with post-traumatic arthritis, deep vein thrombosis, and sciatic nerve injury (SNI). Therefore, we assess the incidence and outcome of SNI associated with acetabular fractures in this study. Methodology: We applied search keywords across PubMed, clinicaltrail.gov, Scopus, and Cochrane library database from 2002 to March 2022 with the studies reporting SNI associated with acetabular fracture. Patient's demographic details, acetabular fracture type, recoveries rate and time, number of patients with acetabular fracture reporting SNI, and follow-up. Methodological Index for Observational Non-Randomized Studies (MINORS) criteria assessed the quality appraisal of each identified study. Results: This study includes twenty-one studies with a total of 682 patients, 19 iatrogenic SNI, and 44 post-traumatic injuries. Overall incidence of post-traumatic and iatrogenic SNI associated with acetabular fractures was 9% [95% CI: 6%-11%] and 5% [95% CI: 3%-7%] respectively. The overall recoveries rate from iatrogenic SNI and post-traumatic SNI associated with acetabular fracture were 55% (95% CI: 22%-83%) and 68% (95% CI: 53% -81%), respectively. The overall quality score of all included studies was 64.28± 7.43% (R: 56.25 % -81.25%), with seven studies below 60%. In most cases, Recoveries of sciatic nerve injury occur within 2-24 months after any open reduction and internal fixation (ORIF). Conclusion: This review estimates SNI incidence with acetabular fracture and recoveries rates. However, this study fails to report the association of SNI with specific acetabular fracture types due to insufficient reported data across eligible studies