Acute lumbosacral plexopathy from gluteal compartment syndrome after drug abuse: a case report.

Acute lumbosacral plexus injury from gluteal compartment syndrome is extremely rare. Physicians should be aware of this diagnosis when examining patients with altered mental status, prolonged immobilization, and gluteal muscle compression. This case report presents a patient with acute complete left lumbosacral plexus paralysis and acute renal failure after gluteal compartment syndrome secondary to prolonged immobilization from drug abuse. Clinical examination, imaging of the pelvis, renal function, creatine phosphokinase, and urine myoglobin were indicative of gluteal compartment syndrome and rhabdomyolysis. Electrodiagnostic studies showed complete limb paralysis. Medical treatment and rehabilitation was administered. Renal function recovered within the 1st week; function at the proximal muscles of the left lower limb improved within 6 months, with mild discomfort on sitting at the buttock, foot drop, and sensory deficits at the leg and dorsum of foot.

Common peroneal nerve palsy after grade I inversion ankle sprain.

This case report presents a 28-year-old man with foot drop 48 hours after a grade I inversion ankle sprain. Clinical examination and electrodiagnostic studies showed common peroneal nerve palsy. The patient was managed with conservative treatment and rehabilitation and recovered completely 4 months after the injury. Physicians should be aware of the possibility of delayed peroneal nerve injury after grade I ankle sprain. Function of the peroneal nerve should be evaluated in all patients with inversion ankle sprain as part of initial and follow-up evaluations. Early electrodiagnostic studies are helpful to localize and provide indications of the severity of the injury.

Selective percutaneous myofascial lengthening of the lower extremities in children with spastic cerebral palsy.

Children with spastic cerebral palsy commonly acquire lower extremity musculoskeletal deformities that at some point may need surgical correction. The authors present 58 children with spastic cerebral palsy who underwent selective percutaneous myofascial lengthening of the hip adductor group and the medial or the lateral hamstrings. All the patients were spastic diplegic, hemiplegic, or quadriplegic. The indications for surgery were a primary contracture that interfered with the patients' walking or sitting ability or joint subluxation. Gross motor ability and gross motor function of the children were evaluated using the gross motor function classification system (GMFCS) and the gross motor function measure (GMFM), respectively. The mean time of the surgical procedure was 14 minutes (range, 1 to 27 minutes). All patients were discharged from the hospital setting the same day after the operation. There were no infections, overlengthening, nerve palsies, or vascular complications. Three patients required repeat procedures for relapsed hamstring and adductor contractures at 8, 14, and 16 months postoperatively. At 2 years after the initial operation, all the children improved on their previous functional level; 34 children improved by one GMFCS level, and 5 children improved by two GMFCS levels. The overall improvement in mean GMFM scores was from 71.19 to 83.19.