İntramüsküler Enjeksiyona Bağlı İnferior Gluteal Sinir Yaralanması

Abstract

Amaç: Bu çalışmanın amacı intramüsküler (İM) enjeksiyona bağlı gelişen inferior gluteal sinir (İGS) yaralanmasının klinik özelliklerinin belirlenmesidir. Gereç ve Yöntemler: Klinik ve elektrodiagnostik özellikleri İM enjeksiyona bağlı gelişen siyatik sinir (SS) ve olası İGS yaralanmaları ile uyumlu olan hastalar bu geriye dönük çalışmaya dahil edildi. Gluteus maksimus (GM) kasında güçsüzlük ya da GM kasında iğne elektromiyografi (EMG) anormalliği olan hastalarda İGS yaralanması olduğu kabul edildi. Bulgular: Sadece SS yaralanması olan 44 (%95,6) hasta, hem SS hem İGS yaralanması olan 1 (%2,2) hasta ve sadece İGS yaralanması olan 1 (%2,2) hasta mevcuttu. Sadece İGS yaralanması olan hastanın şikayetleri İM enjeksiyondan sonra saatler ile günler içinde oluşmuştu ve bu hastanın kas güçsüzlüğü yoktu. Hem İGN hem SS yaralanması olan hastanın şikayetleri İM enjeksiyondan sonra dakikalar ile saatler içinde oluşmuştu ve bu hastanın ayak plantar fleksiyonunda hafif derecede güçsüzlük mevcuttu. Sadece SS yaralanması olan hastaların 40’ında şikayetler İM enjeksiyonu takiben hemen ya da saniyeler içinde ortaya çıkarken geri kalan 4 hastada ise şikayetler IM enjeksiyonu takiben dakikalar ya da saatler içinde oluşmuştu. Sonuç: SS yaralanması ile karşılaştırıldığında nadir olsa da, İM enjeksiyon ile İGS yaralanabilir. Bu nedenle İM enjeksiyon ile ilişkili şikayetleri olan hastalarda GM kası iğne EMG ile değerlendirilmelidir. İM enjeksiyonlara bağlı gelişen sinir yaralanmalarında kas güçsüzlüğü oluşmayabilir.

Keywords

• Elektromiyografi
• inferior gluteal sinir
• intramüsküler enjeksiyon
• siyatik sinir

Inferior Gluteal Nerve Injury Due to Intramuscular Injection

Abstract

Aim: The purpose of this study was to determine the clinical features of the inferior gluteal nerve (IGN) injury due to intramuscular (IM) injection. Material and Methods: Patients with clinical and electrodiagnostic features of the sciatic nerve (SN) and possible IGN injuries due to IM injection were included in this retrospective study. The presence of an IGN injury was considered in patients with weakness in the gluteus maximus (GM) muscle or in those who demonstrated needle electromyography (EMG) abnormality in the GM muscle. Results: There were 44 (95.6%) patients with an SN injury only, 1 (2.2%) patient with both an SN and an IGN injury, and 1 (2.2%) patient with an IGN injury only. The complaints of the patient with an IGN injury only occurred within hours to days after the IM injection; this patient had no muscle weakness. The complaints of the patient with both IGN and SN injuries occurred minutes to hours after IM injection; this patient had mild weakness in the plantar flexion of the foot. In 40 of the patients with only an SN injury, complaints occurred immediately after or within a few seconds following the IM injection, while complaints occurred within minutes to hours in the remaining 4 patients. Conclusion: Although rare when compared to SN injury, the IGN can be injured by IM injection. Therefore, the GM muscle should be examined with needle EMG in patients with complaints associated with IM injection. Muscle weakness may not occur in nerve injuries due to IM injections.

Keywords

• Electromyography
• inferior gluteal nerve
• intramuscular injection
• sciatic nerve

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