Preventing Sciatic Nerve Injury due to Intramuscular Injection: Ten-Year Single-Center Experience and Literature Review.
OBJECTIVE
Sciatic nerve injury is the most frequent and serious complication of intramuscular gluteal injection. This study aims to highlight the incidence and causes of this continuing problem and to discuss the relevant literature. < p < MATERIAL and METHODS: A total of 217 subjects who were diagnosed with sciatic nerve injury in our neurophysiology laboratory between 2003 and 2013 were examined. Sensory and motor transmission studies and needle electromyography were performed by conventional methods in the two lower legs and the results were compared between each leg.


RESULTS
Of the subjects who experienced a sciatic injury secondary to intramuscular injection, 59 (27.2%) were female and 158 (72.8%) were male. In all subjects, the dorsogluteal site of the buttocks was selected for intramuscular injection. Sciatica occurred on the right side in 91 subjects, on the left side in 125, and bilaterally in one. The peroneal nerve was more affected than the tibial nerve. The most used agents were non-steroidal anti-inflammatory drugs. According to follow-up electromyography findings of 103 subjects, significant sequelae remained in 2/3 of cases.


CONCLUSIONS
The occurrence of sciatic neuropathy after gluteal injection causing permanent sequelae and leading to medicolegal problems is relatively rare. We suggest a double quadrant drawing technique in each gluteal region. We also draw attention to this issue with postgraduate and in-service training programs of medical staff, and providing continuity in education can reduce this serious complication.
Gaziantep University, School of Medicine, Department of Neurology, Gaziantep, Turkey.
Sirma
S
Geyik
Murat
M
Geyik
Remzi
R
Yigiter
Samiye
S
Kuzudisli
Sadullah
S
Saglam
Mehmet Ali
MA
Elci
Mustafa
M
Yilmaz
D000293:Adolescent; D000328:Adult; D000368:Aged; D002081:Buttocks / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012584:Sciatic Nerve / Q000293:injuries*; D020426:Sciatic Neuropathy / Q000453:epidemiology*; D012585:Sciatica / Q000453:epidemiology*; D055815:Young Adult