Loss of the sciatic nerve may result in paralysis and sensory loss of the leg. Among indications for lower limb amputation is blunt trauma to the nerve that is feared to have no chances of recovery. Injuries of thermal in nature are thought to have an extensive damage far from the site of injury and are thus unlikely to recover. The injured nerve is likely to heal by fibrosis and scarring making it difficult for any axons to go through it. The only hope for such recovery is removal of all injured sections followed by the nerve repair with a nerve graft or nerve transfer. With advances in microsurgery more and more injured nerves that were otherwise considered unsalvageable are now routinely reconstructed with relatively good outcomes. A good proportion of this are nerve injuries of the upper limbs such brachial plexus, median, ulnar and radial nerve injuries. Compared to the upper limb nerve injuries there is little data on the outcomes of lower limb nerve injuries. The tendency towards amputation of the lower limb following blunt trauma to the sciatic nerve is much higher than the upper limb. We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes.

Massive Scrotal lymphoedema is a debilitating condition that could result in both psychological and physical trauma to the patient. Irrespective of the cause of this condition, surgery remains the cornerstone in its management. A variety of surgical procedures have been described with varied degree of success. A total of eight patients with massive scrotal lymphoedema of ages between 15 and 60 years were managed by the authors. The mean excision of the scrotal tissue was 5.7 kilogrammes. All patients had post excision defect reconstructed with bilateral scrotal flaps. No skin grafts were utilized in any patient. They all healed well without any complications and were able to resume to their normal functions within nine weeks. No recurrence was noted at two years of follow up. Bilateral scrotal flap is an effective method of managing massive scrotally mphoedema. It allows for massive removal of scrotal tissue and primary repair of the defect using scrotal tissue that allows for early return to work and sexual activities. The complications are minimal and there is high patient satisfaction.