Isolated contracture of the rectus femoris muscle(1).pdf

ISOLATED

CONTRACTURE

OF THE

RECTUS

FEMORIS

MUSCLE

Case Report

L. CSINK

and J. IMRE, SZEGED,

HUNGARY

Froni

the Departimient

of Surgery,

Medical

University,

S:eged

A girl of twenty

had complained

of pain in the right leg when walking,

early fatigue

and a

limp,

since

breaking

the right

ankle

three

years

before.

She had

not had any other

accident

or any illness.

The knee could

not be flexed

without

flexing

the hip (Fig.

1). Conversely

the hip could

not be extended

without

extending

the knee;

indeed,

extreme

extension

of the hipwas

impossible

even with the knee fully extended.

Other

hip movements

were

free.

The patient

walked

with a

slight

limp because,

to avoid

concomitant

flexion

of the hip,

she did not bend

her knee

and

consequently

tilted

her

pelvis

slightly

to the

left.

The

Trendelenburg

test

was

negative.

Radiographs

of the right

hip and ankle

were

normal.

FIG. I

Before

operation.

Flexion

of the knee

caused

immediate

Ilexion

the hip.

FIG. 2

After operation.

Flexion

of the knee is free.

The upper

part of rectus

femoris

was explored

and found

to be thickened

and contracted.

It was divided

close to its origin.

At once the hip could

be freely extended,

even with the

knee bent.

The wound

healed

normally,

and functional

treatment

was begun

ten days after operatioll.

Two weeks

later all movements

of the hip were completely

free, and the knee could

be bent

to a right

angle

without

flexion

at the hip (Fig.

2).

The gait was normal

and the patient

had

no complaints.

We suppose

that, when

the ankle

was broken,

the hip and knee may have been forcibly

hyperextended,

with consequent

rupture

of the uppermost

third of the rectus

femoris

muscle

and subsequent

scarring

and shortening.

VOL. 45 B, NO. 1, FEBRUARY

1963

145

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