Sciatic nerve injection injury in children: Management and outcome

Abstract

Background: Sciatic nerve injury is a common complication following IM gluteal injection in children. A controversy still exists regarding management and outcome.Objective: To find the outcome of conservative and surgical treatment and compare it with other studies.Patients and Methods: This is a retrospective study of 24 children( less than 15 years old) with sciatic nerve injection injury at the gluteal region. The child age, gender, type of injection drug, time of injury with complete neurological examination and EMG study were recorded. Conservative treatment including physiotherapy and surgical treatment including surgical exploration and neurolysis at the buttock region were done with follow-up 6 months to one year.Results: Patient’s age ranged from 6 months to 15 years; there were 18 male and 6 female. The most common IM drugs are analgesic in 40% and antibiotic in 18%. Neurological complaint was 22 foot drop (33.3%) and pain in 2 patient (8.7%). Surgery was done in 16 cases (66.6%) and 8 patients (33.3%) were treated conservatively . Outcome of surgery was good in (62.5%) and poor in (37.5).Conclusions: we recommend surgery 2-3 months after conservative treatment including physiotherapy, analgesia, and EMG follow up, if no neurological recovery occurred. The outcome of surgery was good in the child with sciatic nerve injection injury