IATROGENIC SCIATIC NERVE INJURIES FOLLOWING GLUTEAL INTRAMUSCULAR INJECTION AMONG CHILDREN

Abstract

The objective of this is to provide an overview of iatrogenic sciatic nerve injuries following gluteal IM injection, to determine predisposing factors and the outcome of a conservative treatment of patients with the aim of highlighting practical preventive measures to improve the health of the children by preventing disabilities through safe injection practice in Mosul city. A retrospective study of all children had iatrogenic sciatic nerve injuries following gluteal intramuscular injection were evaluated and treated at Rheumatology and Medical Rehabilitation Unit in Al – Salaam Teaching Hospital and from private clinic of Rheumatology and Medical Rehabilitation in Mosul city, between March 2013 and January 2014. A total of 33 children were enrolled in this study. Of these, 17 patients (51.5 %) were males and 16 patients (48.5 %) were females, with ages ranging from 1 month to 7 years (mean age was 1.9 years). Nineteen cases (57.6 %) aged between 1 and 6 months. Most patients were poor and from low social class, 90.9 % of the cases were sustained their nerve injury by nurses, and Antibiotics that mixed with other drugs simultaneously were the offending agents in 81.8 % of patients. Foot drop is the commonest presenting clinical feature (63.6 %). Complete recovery was reported in 16.7 % of the patients, partial recovery in 73.3 % and 10 % had no clinically measurable improvement from the baseline. Injection-induced sciatic nerve injury is common among pediatric patients in our city. Electrophysiological examinations provide significant clues about the prognosis and treatment. The role of early rehabilitation is important for smooth recovery with prevention of complications which lead to deformity and disability. It is also emphasized that in order to reduce the frequency of this handicapping condition, intra glutael injections to the infants should be prohibited and should be prescribed only when mandatory, not mix more than one drug in same syringe and should be administered by well- qualified and competent personnel.