The aim of this case study is to evaluate the result of early surgical repair of complete cut sciatic nerve injury. A case of sciatic nerve injury at thigh level, the etiology of the injury was close range high velocity military weapon shot which resulted in open fracture of the left femur, Gustillo type IIIB and neurotemesis of sciatic nerve at thigh level, primary epineural repair was performed. Muscle strength and reflex changes were observed during stages of treatment. Muscle strength was assessed according to the British Medical Research Council scale. The Semmes-Weinstein monofilament test was used for sensory evaluation. The follow-up period was 2 years. The Tibial nerve component the gastrocnemius/soleus muscle strength recovered completely (power M5) and adequate plantar protective sensation, for the peroneal nerve component the muscle strength assessed as follows: anterior tibialis M4, extensor digitorum M5 and extensor hallucis M4, with adequate sensation on the dorsum of the foot. Conclusion: low expectation following sciatic nerve repair in the past is now replaced by more optimistic results with early primary repair of sciatic nerve injury even in contaminated wounds, and with vigorous prolonged physiotherapy and use of proper orthosis.
