Case of the week - 6/2/97

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

9 yo girl born with left femoral hernia (otherwise healthy). Underwent herniorrhaphy shortly after birth. Walked at one year (did not crawl) and developed pelvic obliquity with right pelvis 2 cm higher than left (no leg length discrepancy) and consequent scoliosis. Complained of pain in the area of the left hip, especially anteriorly, and two years ago began to complain of a similar pain in the right hip. A left femoral nerve palsy was diagnosed (due to the previous surgery) and a femoral nerve transplant was performed in 1995. No improvement was seen in her gait, but she is now pain-free. She continues to walk with the pelvis rotated forwards, and trunk leans to the right during the left stance phase (see picture), with the upper-limb being thrust out at that time.

Frontal plane picture taken in early left stance

Trunk Kinematics

Joint Kinematics
Joint Kinetics

Right-side Electromyography
Left-side Electromyography

... points for discussion:

  • What effect has the femoral nerve lesion had?
  • Why does the trunk lean to the right during left stance?
  • What is responsible for the abnormal pelvis rotation in the transverse plane?
  • Why does the right knee fail to extend fully in mid-stance?

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    Maintained by DDr. Chris Kirtley, Andreas Kranzl & Dr. Andreas Kopf
    Last modified on Friday, 7-Feb-97.

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