Femoral nerve palsy due to iliacus hematoma has been reported previously. Its incidence has increased because of the widespread use of anticoagulants and revision hip surgery. Surgical hematoma evacuation has been highly recommended in patients with coagulopathy. In healthy patients with posttraumatic iliacus hematoma, previous case reports have revealed excellent results with conservative and surgical treatment for incomplete lesions. This report describes the management of a case of complete femoral nerve palsy secondary to traumatic iliacus hematoma in a young patient. The patient and his parents were informed that data concerning the case would be submitted for publication, and they provided consent.

A fourteen-year-old healthy boy presented with an eleven-day history of pain and weakness in the right lower limb. He had developed these symptoms after a fall while jumping and somersaulting during a basketball game. The pain in the right thigh and knee had begun four hours after the incident while he was walking. That same night, he found that he could not stand from a sitting position because of progressive pain and weakness in the injured limb. On the next day, he sought medical help with the chief symptom of pain in the right knee and sacrum. Because radiographs of the sacrum and pelvis revealed normal findings, the patient was prescribed nonsteroidal anti-inflammatory medication and discharged. Ten days later, the patient again sought help for persistent right knee pain, swelling, and lower-limb weakness. He entered the outpatient department with the aid of a wheelchair and could walk only with crutches. He had not experienced back pain or lower-extremity weakness prior to this episode. Physical examination revealed tenderness of the right thigh and patellar tendon, mild swelling of the medial aspect of the right thigh, and numbness.