Journal of pediatric orthopedics. Part B
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Peripheral neuropathy of the femoral nerve is extremely rare. In the literature, we found descriptions of only 50 similar patients, mainly as a complication of coagulopathies, and none of intrapelvic tumors. Three children with a rare peripheral neuropathy of the femoral nerve as a complication of extraperitoneal pelvic masses are described in this report. ⋯ After removal of the masses, full recovery from the neurological symptoms was observed in two children and the recovery of the patient with Ewing's sarcoma is satisfying, at the 2-year follow-up and at the time of writing. As early surgical debulking of the mass was a good influence on the recovery of the nerve paresis, we believe that is imperative in the treatment process. Medical staff should be aware that a serious illness can lie behind peripheral femoral nerve neuropathy.
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This study was undertaken to review our approach to diagnosis and treatment in a series of 11 patients (mean age 8.2 years) with primary pyomyositis, who had neither an underlying disease nor a compromised immune system. Nine of the children had positive blood cultures, Staphylococcus aureus (eight) and Streptococcus group A (one). The sites of infection were iliopsoas (four), obturator (two), hip adductors (two), levator scapula (one), thoracolumbar paraspinal (one) and gastrocnemius (one) muscles. ⋯ Of five patients with evidence of abscess formation, three underwent percutaneous drainage, whereas two required open surgical drainage. The infection resolved completely without any sequela in 10 children. One patient who developed acute compartment syndrome showed late signs of osteonecrosis of the tibial shaft segment.