11 Cases of Sciatic Nerve Injury Following Intragluteal Injection of Diclofenac

Abstract Sciatic nerve which is responsible for innervation of major part of the lower limb, can be injured with various causes. One of the common sites of this nerve injury is gluteal region. This injury occurs following hip arthroplasty and other surgeries of the hip region, Fx - dislocation of the pelvis and femur, acute external compression of the nerve, intragluteal injections, and some other reasons In the recent years, we have seen several cases of Sciatic nerve injury following Diclofenac intragluteal injection. In the present study, we have reviewed 11 cases clinically and electrodignostically during a 4-year period. All of them has been examined within the first month after injection, and most of them has been tested serially during 2 next years. It should be noted that all of the patients were children, old persons or young thin men. 8 of 11 patients (73%) had complete lesion of common peroneal nerve (foot drop), accompanied by various degrees of Tibial nerve lesion in 4 cases. 3 patients (27%) had incomplete lesion of common peroneal nerve (CPN). Tibial nerve was never involved alone. Axnoal degeneration was the pathophysiology of lesion in all cases. It appears that chemical irritation (toxic neuritis) was the pathogenesis of the lesion. CPN was more involved than Tibial nerve because of its especial anatomic situation. Prognosis of complete lesion was poor and there was no functional recovery. With respect the results of this study, it is recommended to avoid Diclofenac injection in persons below 14 years old, old and thin persons.