Case of the week - 15/05/98

from Univ. Clinic for Physical Medicine & Rehabiliation, Vienna General Hospital

 

Triple left pelvic osteotomy  

Clinical Details

34 year old woman, following a triple left pelvic osteotomy (TPO) in January 1993
for hip dysplasia (metal out May 1995).
Complains of pain over the left Greater Trochanter.
Atrophy of  Tensor fascia lata, gluteus medius and minimus (gluteus superior nerve lesion)
Patient usually walks with a forearm crutch in her right hand.

Physical examination

Hip extension-neutral-flexion: left 5/0/110,  right 10/0/130

Manual muscle test (MRC grading)

Hip abductors:        left  4        right  2

Knee flexors:          left  4        right  4

Knee extensors:       left  4        right  5

Movies (PC users get the QuickTime plug-ins here - right mouse-click "Save Link as..." - Windows 95/NT and 3.1)

The movies will open in new browser windows so you can view them simultaneously with analysis.
 
 
sagittal 
 frontal
movie format  QuickTime QuickTime
  left side front view
  right side rear view
3D Kinematics ... Joint Kinetics  ... Trunk Kinematics (Motion Analysis Corp.)
(without the forearm crutch)

Poly-Electromyography (Noraxon) ... Right-side..... Left-side

Note: on the left side the gait cycle is, unusually, from toe off to toe off, and the blue bars indicating normal activity are incorrect - she actually shows normal activity from initial contact to the next inital contact (marked by the vertical line). EMG of the right side is, as usual, from  initial contact to inital contact and the blue bars in this case correctly represent normal activity.

... points for discussion:

What people said...

Case supplied by Mag.Andreas Kranzl and Dr. Andreas Kopf
from Univ. Clinic for Physical Medicine & Rehabiliation, Vienna General Hospital
 

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Maintained by DDr. Chris Kirtley, Andreas Kranzl & Dr. Andreas Kopf
Last modified on Wednesday, 27-Feb. 1998.

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