Thigh swelling and pain in a 35-year-old woman.
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A sciatic nerve lesion secondary to compression by a heterotopic ossification is rare. Operative release of the encased sciatic nerve in some cases may restore the function of the nerve partially or completely. However, in some cases the injury may be permanent. An electrophysiologic study is very useful to determine the location and severity of nerve damage, including axonal loss, demyelination, or both. An electrophysiologic study can emphasize the portion of the sciatic nerve that has been involved the most (lateral versus medial or peroneal versus tibial). In some cases an electrophysiologic study can suggest whether surgery should be postponed if a recovery pattern from the nerve injury is obvious. The prognostic value of follow-up studies is considerable. The authors reviewed literature available to them since 1971 and found 6 cases, including their own. This is the first attempt to put together all the information available in the literature about this condition.
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A fibrous band associated with the rectus femoris and presenting for the first time in an 18-year-old boy is described. There were no congenital anomalies and no history of intramuscular injections, and this is believed to be the first report of its kind in the orthopaedic literature. Knee flexion was greatly improved by excising the band.