Post-injection Injuries and Polio

  • J. Norgrove Penny
  • Coleen S. Sabatini
  • John Ekure
  • David A. SpiegelEmail author
  • Hugh G. Watts


Injection-induced injury during childhood is common. The usual clinical manifestations include (1) foot drop, (2) equinovarus, (3) buttock abscess, (4) gluteal fibrosis, and (5) quadriceps fibrosis. Injection injury is more likely in newborns and small babies where the skin and nerves are in closer proximity to each other than in older children. Many of the intramuscular injections given annually in developing countries are unnecessary yet are administered due to patient or family demand and caregiver overprescription. There is a prevalent belief in traditional settings that painful injections are more powerful and effective, even when adequate and recommended oral treatments are readily available. In many African languages, the words for “fever” and “malaria” are the same, and all fevers are treated as if they were malarial.

Suggested Reading

  1. Alves K, Penny N, Ekure J, Kobusingye O, Katz JN, Sabatini CS. Burden of gluteal fibrosis and post-injection paralysis in the children of Kumi, Uganda. BMC Musculoskelet Disord. 2018;19:343. Open Access:. Scholar
  2. Huckstep RL. Poliomyelitis, a guide for developing countries. 1975th ed. Edinburgh: Churchill Livingstone; 1986. Available at Scholar
  3. Joseph B. Polio revisited: reviving knowledge and skills to meet the challenge of resurgence. J Child Orthop. 2015;9:325–38. Open Access: Scholar
  4. Krul J, editor. Rehabilitation surgery for deformities due to poliomyelitis. Techniques for the district hospital. Geneva: World Health Organization; 1993. Open Access: Scholar
  5. Naddumba EK, Ndoboli P. Sciatic nerve palsy associated with intramuscular quinine injections in children. East Cent Afr J Surg. 1999;4:17–20. Open Access: Scholar
  6. Watts HG. Orthopaedic techniques in the management of the residua of paralytic poliomyelitis. Tech Orthop. 2005;20:179–89. Available at Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • J. Norgrove Penny
    • 1
  • Coleen S. Sabatini
    • 2
  • John Ekure
    • 3
  • David A. Spiegel
    • 4
    • 5
    Email author
  • Hugh G. Watts
    • 6
  1. 1.Branch for International Surgical Care,University of British ColumbiaVictoriaCanada
  2. 2.Department of Orthopedic SurgeryUniversity of California San Francisco Benioff Children’s Hospital OaklandOaklandUSA
  3. 3.Kumi Orthopedic CenterKumiUganda
  4. 4.Division of Orthopedic SurgeryChildren’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA
  5. 5.Hospital and Rehabilitation Centre for Disabled Children (HRDC)BanepaNepal
  6. 6.Shriners Hospital for ChildrenPasadenaUSA

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