The sciatic nerve, posterior cutaneus nerve of thigh, and inferior gluteal nerve are branches of sacral plexus. They leave the pelvis via greater sciatic foramen and arises in gluteal region in infra piriformis fossa. The sciatic nerve usually divides at the upper angle of the popliteal fossa to common peroneal and tibial nerves. There are different variations in course of these nerves. Here common peroneal part of sciatic nerve, part of posterior cutaneous nerve of the thigh and inferior gluteal nerve leave the pelvis above and tibial part of sciatic nerve and part of posterior cutaneous nerve of thigh pass inferior to the piriformis muscle to enter the gluteal region. Variations in these three nerves are rare and are of clinical and surgical importance.

Introduction & Objective: Infectious complications of intramuscular injections in the gluteal region are still noticeable. Gluteal abscess formation after injection is more important because of probably need to surgical incision and drainage. There are several factors that cause the formation of abscess due to injection in gluteal area that controlling of them can play a role in preventing the occurrence of abscess. Materials & Methods: The aim of this study was to investigate the demographic and clinical features of patients with gluteal injection abscesses. 125 patients who had undergone incision and drainage due to were included in the study in hospital centers of Babol University of Medical Sciences during 2004 to 2017. The data consist of demographic features, injected drug type, abscess gram stain and culture were collected and interpreted by SPSS v 20. Results: Of the 125 patients studied, 48 (38. 4%) were male and 67 (53. 6%) were female. 40 patients with BMI less or equal to 30 and 85 had a BMI of over 30. NSAIDs were most injected agents. The duration of hospitalization was 1 to 3 days after surgery and the average of wound healing time was 15 days. Conclusions: In this study, female sex and obesity were two factors that were more associated with the incidence of injection site abscesses. More attention is paid to the proper technique and the choice of injection needle size appropriate to each patient is one of the factors that can prevent the injection site abscess.

Sciatic is the thickest nerve of the body with three quarter of an inch. It is forms from L4, L5, S1, S2 and S3 of spinal nerves as a part plexus in pelvis.It leaves the pelvis via great sciatic foramen, and aises in gluteal region in infra piriformis fossa. Then passes between great trochanter and ischial tuberosity and arrives to the posterior surface of thigh. At the level of superior angle of pobliteal fossa, it divides into two common, proneal and tibial branches. Muscular injection in upper lateral part of gluteal region is performed within gluteus medius and minimus muscles. The former is carried out with a considerable distance to avoid any harm to sciatic nerve. However this variation that includes two parts of sciatic nerve passes throw the supra and infra piriformis fossa is an important one. The later variation induces proximity between nerve and injection site, particularly in neo natales, furthermore, recognition of such variation helps in identification of piriformin syndrome. This type of variation is regarded as one of the rarest type of variation, and has not between referred to in many anatomical dictionaries.

Sciatic nerve is the thickest nerve of the body which is formed by ventral branches of L4, L5, S1, S2 and S3 of spinal nerves as a part of sacral plexus in pelvis. It leaves the pelvis via the greater sciatic foramen below piriformis muscle and descends between the greater trochanter and ischial tuberosity, along the back of the thigh and dividing into the tibial and common peroneal (fibular) nerves, at a varying level proximal to the knee. In addition, the piriformis muscle, the intrapelvic muscle, may compress the sciatic nerve and causes the piriformis syndrome. At present case, sciatic nerve was divided in the pelvis and left the pelvis via supera piriformis, inferapiriformis and interapiriformis. According to the reports about the variations of sciatic nerve regarding to its leaving and dividing point, it is important in surgical operations, muscular injection in gluteal regions and piriformis syndrome.

Hydatid cyst caused by Echinococcus granulosus usually involves lung and liver but can appear in other organs. We report a 29-yr-old woman presented to Fatemi Hospital, Ardabil, Iran in 2017 with progressive painful swelling of the left gluteus which in imaging showed hydatid cyst. The cyst was successfully en blocked and the patient was discharged on albendazole treatment with no recurrence in the symptoms during the first week, first and second months after surgery follow-up and in the final visit at third months. In the endemic regions, the possibility of hydatid cysts should be considered in differential diagnosis of any cystic mass.

Hydatid cyst locates in the liver (70%), lungs (25%) and rarely in other body tissues. Cases with gluteal muscle localized hydatid cyst are rarely seen in literature. In this case report, a woman with hydatid cyst that was located in gluteal muscle was discussed. After the patient had been diagnosed, complete surgical excision was performed with the patient. Albendazole treatment was applied in preoperative and postoperative period to decrease local recurrence risk.

BACKGROUND: Lesions in perineal area are common. The usual treatment is coverage by skin graft and flaps which may be local, pedicled or free types. In this paper V-Y flaps were used to cover the defects.METHODS: V-Y flaps were used in the gluteal area in 15 patients. Lesions were due to different causes.RESULTS: Of 15 patients, 11 were males and 4 were females. Their ages ranged from 3 weeks to 52 years old. Two cases were due to myelomeningocele, necrotizing fasciitis (2 cases) and the rest were due to bed sores (11 cases). The flaps were located over the trochanter (3 cases), ischial (6 cases) and sacral (6 cases). Good healing and durable coverage were obtained in all cases except one case.CONCLUSION: V-Y flap as a working horse flap is recommended in the gluteal area.

Background and Aims Most women experience weakness and inhibition of the gluteal muscles, which negatively affects athletic performance and is known to cause multiple injuries and chronic pain. This study aimed to determine the effect of corrective exercises on gluteal muscles strength, endurance, and power in women with gluteal muscles weakness and inhibition.Methods We purposively identified 28 non-athletic women aged 25 to 45 years who were referred to Babolsar Rehabilitation Clinic (Babolsar City, Iran) for physiotherapy due to reasons such as fracture, strain, sprain, and dislocation of the upper extremity joints. They experienced inhibition and weakness of the gluteal muscles. After completing the physiotherapy course and returning to normal life, they entered the present study and were randomly divided into the control (n=15) and exercise (n=13) groups. The exercise group performed a corrective exercises program including inhibitory, lengthening, activating, and strengthening exercises with theraband for 8 weeks (3 sessions per week and 30 to 45 minutes per session). The power of extensors, abductors, and external rotators of gluteal muscles was measured using the Diako cable machine and based on the formula of one-repetition maximum. The power and endurance of gluteal muscles were measured by the single-leg glute bridge test and the vertical jump test in two groups. The data were analyzed by covariance analyses.Results The results showed a significant improvement in the strength of the gluteal muscles in the movements of extension, abduction, and external rotation of the thigh, also in the endurance and power of the gluteal muscles in the exercise group compared to the control group in the post-test (P<0.05).Conclusion This study showed that corrective exercises, including inhibitory techniques, lengthening, activating, and strengthening exercises, have the necessary components to improve the strength, endurance, and power of gluteal muscles. Therefore, this exercise program is recommended for people with weakness and inhibition of the gluteal muscles.