Transient simultaneous sciatic and femoral nerve palsy secondary to iliacus and gluteal hematomas following heparinization for pulmonary embolus in a patient with posterior hip dislocation.

Abstract

Sciatic nerve palsy as a result of a posterior hip dislocation has been reported in the literature. Femoral nerve palsy as a result of a iliacus hematoma has also been documented. However, a simultaneous sciatic and femoral nerve palsy occurring after heparinization for a pulmonary embolus in a patient with a posterior hip dislocation has not been reported. This combined nerve palsy was found in a 64-year-old white woman who had been involved in a motor vehicle accident and sustained a posterior hip dislocation. This patient subsequently had a pulmonary embolism, was heparinized, and then developed a large iliacus and gluteal hematoma, resulting in a simultaneous sciatic and femoral nerve palsy. Without treatment, the patient regained motor and sensory of the sciatic nerve in a few days, and a gradual improvement of function of her femoral nerve was evident over several months.