Transient femoral nerve palsy in spica cast treatment for developmental dysplasia of the hip

Abstract

A 4 months and half female child come to our attention for congenital dislocation of the left hip, previously treated in another hospital with abduction bracing, without satisfactory results. After progressive longitudinal bilateral traction, closed reduction under general anesthesia was performed and a spica cast was applied in the so-called human position. The patients remained in the spica cast for 6 weeks and then the plaster cast was renewed in narcosis for another 6 weeks. Once the second cast has been removed left femoral nerve palsy was detected. Orthopaedic treatment was interrupted and in 3 months the nerve completely recovered, while the hip was still stable. We followed the child regularly since then, she is now five years old, she is totally asymptomatic, X-rays shows a residual acetabular dysplasia, with no sign of avascular necrosis.

Pemberton’s acetabuloplasty without cast application for the treatment of acetabular dysplasia in older children: A case series

“…Furthermore, the cast has many complications, including joint stiffness, pressure sores, skin rashes, skin ulceration, and infection with a possibility to reach septic shock, transient femoral nerve palsy, and cast-saw injuries during removal. [12][13][14][15][16][17][18][19] Superior mesenteric artery syndrome has been reported as a complication in a 10-year-old girl after hip spica application. [20] Transportation in vehicles becomes a real burden and may become unsafe.…”

Spinal disorders and mastication: The potential relationship between adolescent idiopathic scoliosis and alterations of the chewing patterns

“…Some studies evaluating the relationship between malocclusion and scoliosis described an increased prevalence of unilateral Angle Class II malocclusion, 17 an increased risk of crossbite 15 and left-right occlusal asymmetries 18 ; however, there was no agreement between the studies. 19 A recent systematic review concluded that there was no clear evidence of a causal relationship between spinal deformities and malocclusion and underlined the limited quality of the evidence available to support it. 20 Nevertheless, even though the results are not directly translatable to humans, three animal studies [21][22][23] showed the role of induced malocclusion on the irreversible degeneration of the spine, manifesting as scoliotic curves.…”