(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect patient privacy) Abstract: The patient was a 30-year-old male who was injured in a car accident on his left hip and subsequently developed left hip pain, deformity, and limitation of movement with loss of sensation and motor function of the left lower extremity. After examination of the patient’s comminuted fracture of the posterior wall of the left acetabulum with sciatic nerve injury, foreign body removal, internal fixation of the left acetabular fracture with incision and repositioning plate, sciatic nerve exploration and release, and pharmacological treatment, the patient’s fracture healed and the nerve function of the left lower limb was partially restored. [Basic information] Male, 30 years old [Disease type] Sciatic nerve injury, left acetabular comminuted fracture [Hospital] Liaocheng Second People’s Hospital [Consultation date] February 2021 [Treatment plan] Surgical treatment (foreign body removal, left acetabular fracture incision and internal fixation of plate, sciatic nerve exploration and release) + intravenous injection (cefazolin sodium for injection + heptazocine sodium for injection + The patient was admitted to the hospital as an emergency patient with a car accident injury. The patient was lying flat on a transport bed, with a machine part straddling his perineum, with a painful face, shortness of breath, and a clear consciousness. The patient was in pain, with shortness of breath, clear consciousness, and moaning. After asking the 120 physician about the cause of injury, we learned that the patient was driving a farm vehicle and had a rear-end accident with a large truck, and the patient was riding on the steering wheel of the farm vehicle. The patient felt severe pain in the left hip, did not dare to move, and lost consciousness in the left lower limb. The patient was found to have a foreign body in the perineum (steering wheel remnants), a severe deformity of the left hip, and a drooping left foot, which caused severe pain when the patient touched the injury with his hand. After explaining the CT examination results to the patient and family members, the patient was informed that there was an open comminuted fracture of the left acetabulum and a possible sciatic nerve injury, and that the patient’s condition was not stable at present, so emergency surgery was performed first to clear the fracture and remove the foreign body, and then fracture repositioning and fixation and sciatic nerve exploration surgery were performed after the patient’s condition was stabilized. At the same time, debridement and removal of the perineal foreign body were performed under general anesthesia. The patient was immediately admitted to the ICU after surgery, and on the second day, a 3D reconstruction examination of the pelvis was performed. On the third day, the patient’s condition stabilized, and he was again treated with internal fixation of the left acetabular fracture by incision and repositioning of the plate and release of the sciatic nerve exploration. After surgery, the patient was given cefazolin sodium for injection to prevent infection, heptazocine sodium for injection to reduce swelling, dizocine injection to relieve pain, and methylcobalamin injection to nourish the nerve, in addition to acupuncture and hyperbaric oxygen to promote nerve function recovery rehabilitation treatment. The stitches were removed at 25 days of hospitalization, and the incision healed well without redness, swelling and secretion. Postoperative radiographs showed that the acetabular fracture was in good position and the internal fixation was firm and reliable, so the patient was discharged. At the time of discharge, the patient’s pain at the fracture was significantly reduced and the sensory function of the left lower limb was partially restored, but the left foot drop deformity still existed. The patient was transferred to a local rehabilitation hospital to continue the motor rehabilitation treatment of the left lower limb, and was also given mecobalamin tablets for neurotrophic treatment. Six months after the operation, the fracture was healed, the sensory function of the left lower limb above the knee joint was restored, and the left knee joint could be partially flexed and extended, but the movement of the left ankle was still limited, and the foot drop deformity remained. After a series of treatments, the patient’s fracture was healed, but unfortunately the residual foot drop deformity remained. The patient needs to continue neurological rehabilitation treatment after discharge, at least 3-6 months of oral methocobalamin tablets neurotropism, neurological rehabilitation methods including manual limb function exercise, acupuncture, hyperbaric oxygen, etc. The patient must recognize the slow recovery of this injury, and at the same time, the family needs to do a good job of psychological guidance of the patient to enhance the patient’s treatment confidence and improve the compliance of rehabilitation treatment. In addition, a high protein, vitamin diet, such as the consumption of fish, shrimp and other foods, can promote nerve repair. Harmful substances from tobacco can affect the recovery of nerve function, so patients need to be persuaded to quit smoking. After discharge from the hospital, regular follow-up examinations and electromyography, if necessary, can monitor the recovery of sciatic nerve function. V. Personal insight 1. Sciatic nerve injury is not very common in clinical practice, but when acetabular fracture is accompanied by sensory and activity disorders of the injured limb, the possibility of its occurrence needs to be considered; 2. The recovery of sciatic nerve function is a long process, and the long-term nature and complexity of the treatment of this injury should be fully recognized; 3. 4, good psychological guidance, improve the patient’s compliance, is also the key to achieve good treatment results.