Clinical orthopaedics and related research
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Pyomyositis appears to be increasing in prevalence in temperate climates, and often the orthopaedist is integral in the decision making and care of these patients. This is the first reported case of spontaneous bacterial pyomyositis involving the obturator internus muscle. Deep pelvic infections involving the psoas, iliacus, piriformis, and obturator internus can be a significant cause of morbidity and mortality. ⋯ Because of the pathology's deep location within the pelvis of the patient described here, all 3 tests were integral in the surgical planning, exposure, and proper diagnosis. Although 95% of pyomyositis cases are caused by Staphylococcus aureus, cases of pyomyositis with negative cultures have been described. Consideration should be made of disseminated Neisseria gonorrhoeae in sexually active individuals, and cultures should include Thayer-Martin agar to decrease the likelihood of a false-negative culture result.
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Clin. Orthop. Relat. Res. · Jul 1995
Gluteoperineal gangrene and sciatic nerve palsy after umbilical vessel injection.
Thirteen patients with gluteoperineal necrosis of the skin and subcutaneous tissue without muscle involvement associated with palsy of the peroneal branch of the sciatic nerve were examined at the authors' institution. This syndrome was a complication after umbilical vessel catheterization for injection of medications mainly for respiratory distress and apnea. Skin and subcutaneous damaged tissues required debridement without sedation or anesthesia. ⋯ Surgery was required only to correct the deformity of the foot secondary to muscular deficits. In this series, the final results of the muscles involved secondary to nerve palsy were good in 4 patients, fair in 6, and poor in 3. No excellent result was noted.