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[Coexistent paralytic drop foot and gluteal fibrosis after intramuscular infections--therapeutic implications]
1Kliniki Ortopedii Dzieciecej Instytutu Ortopedii i Rehabilitacji AM w Poznaniu.
Insights
Intramuscular injections in children can lead to paralytic drop foot and gluteal fibrosis. Gluteal fibrosis, often diagnosed years later, can contribute to foot deformities, complicating treatment.
Area of Science:
- Pediatric Orthopedics
- Neuromuscular Disorders
- Rehabilitative Medicine
Context:
- This study examines six pediatric cases presenting with paralytic drop foot.
- The condition developed subsequent to intramuscular injections, specifically intra-gluteal administration.
- Co-existing gluteal fibrosis was a significant clinical feature in all presented cases.
Purpose:
- To report on the clinical presentation and therapeutic challenges of paralytic drop foot following intramuscular injections.
- To investigate the role of gluteal fibrosis in the development and recurrence of foot deformities.
- To highlight the diagnostic delay associated with gluteal fibrosis in this pediatric population.
Summary:
- Paralytic drop foot was diagnosed an average of 5.5 months post-injection.
- Gluteal fibrosis was diagnosed significantly later, averaging 3 years and 7 months after the initial event.
- Hip joint contractures (external rotation and abduction) due to gluteal fibrosis were observed in three cases, potentially exacerbating foot deformities like equinovarus.
Impact:
- Underscores the potential iatrogenic complications of intramuscular injections in children.
- Emphasizes the importance of recognizing gluteal fibrosis as a sequela and its impact on lower limb function.
- Informs clinical practice regarding the long-term monitoring and management of children with a history of intra-gluteal injections and suspected fibrosis.
Abstract:
Six children with paralytic drop foot, which developed after intramuscular injections and who had co-existing gluteal fibrosis are presented in this study. Paralytic drop foot was diagnosed on an average of 5.5 months after intra-gluteal injections. This was the major therapeutic problem. The diagnosis of gluteal fibrosis was made on an average only 3 years and 7 months later. In 3 cases the external rotation and abduction contracture of the extremity in the hip joint, caused by gluteal fibrosis, with active plantar flexors and supinators of the foot could contribute to the recurrence of the equinovarus deformity of the surgically corrected foot.