Foot deformities secondary to gluteal injection in infancy

We report six cases of foot deformities in children due to sciatic nerve dysfunction that appear to have been caused by gluteal intramuscular injection. Of four patients who developed cavovarus foot deformities, two also exhibited a component of ankle equinus. A fifth patient had a calcaneocavus foot deformity. In the sixth patient foot palsy resolved completely 1 year after injury, and no deformities developed. Identification of the muscle imbalance, as well as appropriate correction of the deformity before the implementation of muscle balancing procedures, led to the attainment of a satisfactory plantigrade gait in the first five patients with deformities. Bases on our experience with these six cases and reports in the literature, we recommend that the superolateral gluteal area between the crest of the ilium and the greater trochanter be properly defined as the preferred site for intramuscular injection.