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Monomelic amyotrophy following trauma and immobilization in children
1Department of Neurology, Hospital Nacional de Pediatría Jaun Garrahan,Buenos Aires, Argentina.
Insights
Pediatric limb immobilization for injuries like sprains or fractures can lead to monomelic amyotrophy. This condition causes progressive muscle weakness and wasting in the affected limb after treatment.
Area of Science:
- Neurology
- Orthopedics
- Pediatrics
Background:
- Pediatric limb injuries, including elbow sprains and tibial tuberosity fractures, often require immobilization.
- The long-term effects of immobilization on pediatric neuromuscular function require further investigation.
Observation:
- Two children experienced insidious, progressive weakness and muscle wasting in limbs previously immobilized for injury.
- Symptoms primarily affected muscles near the injury site, sparing distal extremities.
- Neurological examinations revealed no sensory deficits, but electromyography indicated a neurogenic pattern.
Findings:
- The cases suggest a potential link between trauma, immobilization, and the development of monomelic amyotrophy in children.
- Muscle atrophy and weakness appeared months after immobilization, stabilizing over 2-3 years.
Implications:
- This highlights a potential, albeit rare, complication of pediatric fracture and sprain management.
- Further research is warranted to understand the pathophysiology and risk factors for post-immobilization monomelic amyotrophy.
Abstract:
Two children aged 9 and 11 years suffered from left elbow sprain and right anterior tibial tuberosity cortical fracture respectively and were treated with plaster cast immobilization for about 30 days. They regained normal strength afterwards, but 9 and 2 months later developed insidious progressive weakness and wasting in the affected limb, mainly evident in the musculature surrounding the site of injury and sparing hand and foot muscles. Two to three years later the condition stabilized. Sensory abnormalities were not found. Electromyographic examination showed neurogenic pattern confined to the impaired extremity. The focal quality and the unusual disposition of muscle involvement suggest a correlation between trauma and/or immobilization and monomelic amyotrophy.