Injection Injury of the Sciatic Nerve:Unusual Anatomic Distribution of Nerve Damage

Streib, Erich W.; Sun, Sallie F.

doi:10.1159/000115282

Cited by 11 publications

(14 citation statements)

References 11 publications

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“…Anatomical variations in the course and division of the sciatic nerve may be a factor in some cases (11). Affected patients typically experience immediate pain radiating down the limb, with weakness and numbness evolving more gradually (35), exacerbated by secondary scarring. The extent of recovery depends on the severity of the initial injury.…”

Section: Discussionmentioning

confidence: 99%

Sciatic nerve injury from intramuscular injection: a persistent and global problem

Mishra

Stringer

2010

International Journal of Clinical Practice

101

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Summary Background/Aims: An intramuscular (IM) injection into the buttock risks damaging the sciatic nerve. Safe injection practices need to be understood by doctors and nurses alike. The aims of this study were to determine if sciatic nerve injury because of IM injection is a continuing problem and to establish the availability of published guidelines on IM injection techniques. Methods: Intramuscular injection related sciatic nerve injury claims to the New Zealand Accident Compensation Corporation between July 2005 and September 2008 were reviewed. Nursing organisations were surveyed to enquire about guidelines on IM injection. IM injection related sciatic nerve injuries in the medical and medicolegal literature (1989–2009) were systematically reviewed. Results: There were eight claims for sciatic nerve injection injury made to the ACC during the 3‐year study period; all were in young adults. Only one of the nursing organisations contacted had published guidelines on IM injection technique, and these related specifically to immunisation. Seventeen reports of patients with sciatic nerve injury from IM injection were identified comprising a total of 1506 patients, at least 80% of which were children. Nine court decisions finding in favour of the plaintiff were identified, all from the North American legal system. A broad range of drugs were implicated in the offending IM injections. Conclusions: Sciatic nerve injury from an IM injection in the upper outer quadrant of the buttock is an avoidable but persistent global problem, affecting patients in both wealthy and poorer healthcare systems. The consequences of this injury are potentially devastating. Safer alternative sites for IM injection exist. These should be promoted more widely by medical and nursing organisations.

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Section: Discussionmentioning

confidence: 99%

Sciatic nerve injury from intramuscular injection: a persistent and global problem

Mishra

Stringer

2010

International Journal of Clinical Practice

101

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“…8 For obvious reasons, intrafascicular injections can cause more damage to the nerve than extrafascicular or extraneural injections. 19,26 A breakdown in the blood-nerve barrier following nerve injury is well recognized. 8,9 Intrafascicular injection of neurotoxic agents into the rat sciatic nerve produced a marked increase in the permeability of the perineurium and endoneurial capillaries within 30 min after injection.…”

Section: Agents Associated With Sniimentioning

confidence: 99%

Sciatic nerve injection injury

Kim

Park

2014

J Int Med Res

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Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery. Management of nerve injection injury includes drug treatment of pain, physiotherapy, use of assistive devices and surgical exploration. Early recognition of nerve injection injury and appropriate management are crucial in order to reduce neurological deficit and to maximize recovery. Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper outer quadrant of the buttock).

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“…Unusually, patients with predominant or sole damage to the posterior tibial nerve trunk are also reported 6 . The other nerves involved by intramuscular injection injuries are median nerve 7 , peroneal nerve 8 , posterior femoral cutaneous nerve 9 and even more than one nerve in case of infrapyriformis syndrome 10…”

Section: Site Of Injurymentioning

confidence: 99%

Section: Constriction By Scarmentioning

confidence: 99%

“…Extensive scar formation in the perineural tissue results in secondary constriction of the nerve 3 . Even internal fibrosis of the nerve is of importance as a pathogenetic mechanism in injection injuries 6 . Among steroids dexamethasone appears to be the safest and hydrocortisone being most toxic to nerves 14 Pathological alterations in the nerve are evident as early as 30 minutes after injection.…”

Section: Nerve Damage By Neurotoxic Chemical In the Agent Injectedmentioning

confidence: 99%

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Injection injuries of peripheral nerves

Shukla¹,

Bhat²,

Devi³

et al. 2004

The Indian Journal of Neurotrauma

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Inadvertant injection into or in the vicinity is a common cause, but least discussed aspect of peripheral nerve trauma. The recommended treatment has ranged from a conservative approach to immediate operative exposure and irrigation. Treatment options include early neurolysis, delayed exploration with neurolysis, or resection and anastomosis. Prevention is the most important aspect and due care should be exercised while administering intramuscular injection.

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Injection Injury of the Sciatic Nerve:Unusual Anatomic Distribution of Nerve Damage

Cited by 11 publications

References 11 publications

Sciatic nerve injury from intramuscular injection: a persistent and global problem

Sciatic nerve injury from intramuscular injection: a persistent and global problem

Sciatic nerve injection injury

Injection injuries of peripheral nerves

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