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Course of the Sciatic nerve: a Review of Cases Seen at Mulago Hospital, Kampala - Uganda
Kukiriza, J.; Ibingira, C. & Ochieng, J.
Abstract
Background:
The sciatic nerve is the largest in the body with
nerve roots L4, 5 S1, 2, 3. It is
commonly injured in the body particularly following
administration of gluteal
intramuscular injections to children. The nerve usually leaves the pelvis by passing
through the greater sciatic foramen below the piriformis and anterior to the superior and
inferior gamelli and the obturator internus muscles. However, it should be noted that this
usual course varies on many occasions and these variations have been cited as
predisposing factors to certain clinical conditions
including piriformis syndrome,
coccydynia, muscle atrophy, traumatic administration of intramuscular injections leading
to foot drop and bilateral gluteal fibrosis. This study describes the course of the sciatic
nerve among adult subjects at Mulago hospital complex.
Methods:
This was a cross-sectional descriptive study conducted at the department of
anatomy dissection laboratory Makerere University and the associated Mulago teaching
hospital mortuary. Dissections of the lower limbs from the gluteal region through the thigh
to the leg were done to expose the nerves and surrounding structures.
Results:
A total of 80 adult thighs and gluteal regions were dissected in 56 males and 24
females to trace and expose sciatic nerves. All
sciatic nerves were located in the lower
medial quadrant between the ischial tuberosity and
the greater trochanter. In the gluteal
region, the whole sciatic nerve measured 4.2cm, and among subjects with bifurcated
nerves, the tibial and common peroneal nerves were
4.67cm and 3.3cm, respectively, along
a perpendicular line drawn medially from the midpoint between the posterior superior
iliac spine and the greater trochanter.
Conclusion:
The course of the sciatic nerve in the gluteal region is variable and hence,
appreciation of these variations can be useful during clinical and surgical procedures in
the gluteal and thigh regions.
Keywords
sciatic nerve; course; cases
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