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Review Question - QID 2915

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QID 2915 (Type "2915" in App Search)
A 26-year-old male sustains a femoral shaft fracture treated with the implant shown in Figure A. Postoperatively, what muscular deficits can be expected at medium and long-term follow-up?
  • A

Weakness with hip abduction and knee flexion

6%

73/1264

Weakness with hip abduction and knee extension

28%

355/1264

Weakness with knee flexion and knee extension

2%

24/1264

Weakness with hip external rotation and hip abduction

58%

733/1264

Weakness with hip external rotation and hip flexion

6%

73/1264

  • A

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Figure A shows a femoral shaft fracture treated with an antegrade femoral nail. Long term deficits are weakness with knee extension (quadriceps) and hip abduction (glutei muscles).

The referenced study by Kapp et al noted long term quadriceps weakness as well as decreased bone mineral density in the femur (femoral neck by 9%, the lateral cortex by 20% and the medial cortex by 13%). It is unclear whether this is due to the injury, treatment, or a combination of both.

The second referenced study by Archdeacon et al also noted weakness in hip abduction, which showed time dependent improvement. He reports that increased early ipsilateral trunk lean is associated with worse recovery of abduction strength.

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