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Proximal release for injections induced hip flexion contracture in a child: A case report
Doried Diri1, Hakam Alasaad1, Sedra Abou Ali Mhana1
1AL-Andlus Private Hospital, Damascus, Syria.
Insights
This case study shows that proximal release effectively treats isolated rectus femoris contracture caused by injections. Long-term physical therapy is crucial for successful outcomes in pediatric patients.
Area of Science:
- Orthopedic surgery
- Pediatric rehabilitation
Background:
- Quadriceps contracture, often caused by repeated intramuscular injections, can present as isolated rectus femoris or combined quadriceps involvement.
- Iatrogenic injection-induced contractures pose a significant challenge in pediatric musculoskeletal conditions.
Observation:
- A 9-year-old boy presented with recurrent isolated rectus femoris contracture.
- The condition was successfully treated with proximal release surgery.
Findings:
- Proximal release of hip flexion contracture demonstrated efficacy in restoring knee flexion.
- A positive Ely's test indicated the rectus femoris involvement, guiding the surgical approach.
Implications:
- This surgical approach offers a viable solution for iatrogenic quadriceps contractures.
- Comprehensive physiotherapy and diligent follow-up are essential for optimal functional recovery in affected children.
Introduction:
Quadriceps contracture can be congenital or acquired; however, multiple intramuscular injections are one of the major identified causes of this lesion that can manifest in two forms: either isolated rectus femoris or combined with quadriceps contracture.
Case Report:
this article presents a case of a 9-year-old boy with a recurrent isolated rectus femoris contracture that was released proximally with a satisfactory result after one-year follow-up.
Discussion:
Treatment differs based on the degree of knee flexion loss and the affected muscles, as it can be either proximal release or distal quadricepsplasty. Extended physiotherapy and close follow-up are mandatory for successful treatment.
Conclusion:
Proximal release of the hip flexion contracture with positive Ely's test can be effective in restoring knee flexion and improving function in patients with quadriceps contracture induced by iatrogenic injection.
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