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Gluteal Fibrosis

Gluteal Fibrosis. John Ekure Kumi Hospital Uganda. Introduction. 28 cases of gluteal fibrosis From Aug 2004 to May 2005 All bilateral All were severe . Introduction. 26/28 : cause = IM Quinine 2/28 : Cause = Streptomycin / Penicillin One case had paralytic drop foot

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Gluteal Fibrosis

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  1. Gluteal Fibrosis John Ekure Kumi Hospital Uganda

  2. Introduction • 28 cases of gluteal fibrosis • From Aug 2004 to May 2005 • All bilateral • All were severe

  3. Introduction • 26/28 : cause = IM Quinine • 2/28 : Cause = Streptomycin / Penicillin • One case had paralytic drop foot • Fibrous tissue was incised

  4. Introduction • Surgical complications: 1/28 : Temporary Sciatic nerve palsy 2/28 : Deep sepsis

  5. Description of the Cases • O.k , an 8 yr old boy • Difficulty in walking, squatting and sitting for 6yrs • 2° to im quinine at the age of 2yrs • Generally well except for buttocks

  6. Hip flexion 30 ° • External rotation and abduction of 35° was necessary to obtain full flexion of the hips • No adduction or internal rotation was possible with the hips fully flexed • He could not sit on a mat with his knees extended and hips abducted

  7. Both buttocks had scars and were markedly wasted • Difficulty in daily activities • Surgical release improved quality of life

  8. Pt. Profiles : 28 Cases • All < 12 yrs • Males = 44.4% • im quinine = commonest cause • 2 Cases caused by Penicillin or streptomycin

  9. Analysis of the 28 Cases • All children had small gluteal muscle masses • Buttocks had injection scars • Hip flexion in neutral only 30°- 40° • When standing, the child kept an attitude of external rotation of both hips

  10. Analysis of the 28 Cases • Running was impossible !!!! • All bilateral • Sitting impossible except on a high chair, with marked flexion of the lumbar spine • Squatting was only possible in frog position

  11. Pathological findings • During surgery : Very tense Fascia Lata • Muscles replaced by fibrous tissue • Histology : Intramuscular fibrosis without any signs of inflammation

  12. Discussion and Conclusions Gluteal fibrosis may be as a result of repeated im Quinine No cases were diagnosed at birth Surgical treatment is not without complications Gluteal fibrosis is preventable.

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