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[Sciatic nerve in gluteal portion: application of sciatic nerve post injection lesion].

A Ndiaye1, Y Sakho, F Fall

  • 1Laboratoire d'anatomie-organogenèse, Faculté de Médecine, Pharmacie et Odonto-Stomatologie, Service de Neuro-Chirurgie CHU Fann--Dakar, Sénégal. layndiaye@ucad.sn

Morphologie : Bulletin De L'Association Des Anatomistes
|January 12, 2005
PubMed
Summary

Intragluteal injections do not typically cause sciatic nerve injury due to anatomical positioning. Local quinine toxicity is a more likely cause of nerve damage, suggesting alternative administration routes for children.

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Area of Science:

  • Anatomy
  • Neuroscience
  • Pharmacology

Context:

  • Malaria is endemic in the region, making intragluteal injections a common medical procedure.
  • Sciatic nerve injury is an observed complication following intragluteal injections.
  • Understanding the anatomical basis of these lesions is crucial for patient safety.

Purpose:

  • To determine the anatomical features and basis of sciatic nerve lesions after intragluteal injections.
  • To investigate the relationship between sciatic nerve pathway and common injection sites.
  • To explore alternative hypotheses for post-injection sciatic nerve injuries.

Summary:

  • Dissections of 10 adult cadavers revealed consistent sciatic nerve pathways within the gluteal region, primarily through the subpiriformis canal.

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  • The sciatic nerve's cutaneous projection is distant from the upper lateral quadrant, suggesting injections in this area are unlikely to cause direct nerve damage.
  • Anatomical variations in the nerve's pathway were found to be minimal, pointing towards other factors like local drug toxicity (e.g., quinine) as a cause of injury.

    • Impact:

    • Findings suggest that intragluteal injections themselves may not be the direct cause of sciatic nerve injury.
    • Highlights the potential neurotoxicity of quinine and its diffusion as a more probable cause of nerve lesions.
    • Recommends replacing intramuscular injections with intravenous or rectal administration of medications like quinine in children to prevent nerve damage.