Outcomes of Sciatic Nerve Injury Repairs: A Systematic Review.

Background: The objective of this study was to investigate the surgical repair techniques and the outcomes of sciatic nerve injuries in traumatic wounds. Methods: A literature search was conducted using the following keywords:sciatic, nerve, repair, technique, conduit, graft, reconstruction, outcome, rehabilitation, recovery, function, surgery, and NOT anesthesia. Results: In total, 715 studies were retrieved. After abstract review, 13 articles fit the criteria. A total of 2627 repairs were carried out, including nerve grafts (n = 953), suture (n = 482), and neurolysis (n = 1192). Six studies reported good motor outcome, and good sensory outcome was reported across 2 studies. The thigh region accounted for 81.5% of lesions. Sciatic, peroneal, and tibial nerves were all equally affected. Gunshot wounds were the most common mechanism of injury (22.6%). Conclusions: The cumulative evidence demonstrates sciatic nerve injury repair has poor motor and sensory outcomes. This study shows there is a lack of standardized outcome measures, making comparisons very difficult. Graft lengths of <4 cm within the intermediate region yielded more successful outcomes. Further higher quality studies of nerve transfers in the lower limbs are needed to determine the optimal repair to restore sciatic nerve function.

Medical Students Learning on the COVID-19 Front Line.

In this viewpoint, we share our perspectives, as medical students at Imperial College London, on our experiences during our Infectious Diseases placement at Northwick Park Hospital, touching upon other students' experiences at other sites as well. We highlight some of the main drivers of and barriers to medical students seeing patients with COVID-19.