Combined technique for simultaneous reconstruction of ankle instability and tibial lengthening following sacrifice of the sciatic nerve

Abstract

Peripheral nerve sheath tumors require extensive resections, usually with sacrifice of the nerve. Tumors originating from the sciatic nerve may lead to one of the most disabling conditions if associated with sacrifice of the nerve. Gait is altered seriously and patients usually require orthotics. The resulting muscle paralysis and imbalance may lead to ankle instability. We present the case of a patient with ankle instability and tibial shortening secondary to sacrifice of the sciatic nerve, who was treated with a combined technique to address both problems simultaneously. Tibia was lengthened proximally with a circular external fixator over intramedullary nail, while the intramedullary nail was used for a pantalar arthrodesis.