Relapsed hip stiffness after recovery of range of motion in a hip treated for developmental dysplasia of the hip? Think again: A case report
| Autor: | Naif Abdulaziz Alanazi, Hasan Alanazi, Faisal Almalik, Thamer S. Alhussainan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Dysplasia Spasm medicine.medical_treatment Osteotomy Stiffness 03 medical and health sciences 0302 clinical medicine Case report Medicine business.industry medicine.disease Acetabular dysplasia Surgery body regions 030220 oncology & carcinogenesis Orthopedic surgery Examination Under Anesthesia 030211 gastroenterology & hepatology Presentation (obstetrics) DDH business Complication Range of motion |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • How to evaluate complications following DDH treatment. • Muscular spasm can mislead physicians following treatment of DDH. • Hip stiffness vs muscular spasm in DDH patients. • Examination under anesthesia could be the answer for relapsed hip stiffness. • The value of examination under anesthesia in DDH complications. Introduction Several complications have been reported following treatment of developmental dysplasia of the hip (DDH). Local muscular spasm is an extremely rare complication. This case serves to enlighten orthopedists about various and unique presentations of idiopathic local muscular spasm, natural history of such condition, and appropriate treatment. Presentation of case A two-year-old child presented with bilateral acetabular dysplasia for orthopedic evaluation and treated with bilateral simultaneous Dega osteotomy and postoperative cast for 12 weeks. Full range of motion (ROM) of both hips was regained three months after removal of the postoperative cast. Five months later, the child presented with apparent leg length discrepancy, and severe and painless global limitation of the right hip ROM, which initially was thought to be relapsed hip stiffness. Laboratory and radiological investigations were normal apart from pelvic obliquity on radiographs. Symptoms persisted for one month. Examination under anesthesia (EUA) was then performed and revealed full ROM of the involved hip. Physical therapy was started, and hip ROM fully recovered within 3 months without further intervention. Discussion Stiffness, which is one of the most reported complications following surgical treatment of DDH, is usually related to lengthy periods of immobilization and/or surgical treatment. Clinically, local muscular spasm of the hip can mimic stiffness. EUA is invaluable to differentiate the common postoperative stiffness from the rare local muscular spasm. Conclusion Idiopathic local muscular spasm of hip might present clinically as stiffness that pose a diagnostic dilemma to the treating physician. Close observation coupled with physical therapy is sufficient. |
| Databáze: | OpenAIRE |
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