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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 Mar 06

DOI: 10.23736/S1973-9087.17.04513-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Sequential bilateral complete rupture of the rectus femoris muscle in a patient with hereditary spastic paraplegia

Lize RAES 1, Nathalie DRAULANS 1, Anja, Van CAMPENHOUT 2, Els ORTIBUS 3, Koen PEERS 1, Carlotte KIEKENS 1

1 Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium; 2 Department of Orthopaedics, University Hospitals Leuven, Leuven, Belgium; 3 Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium


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BACKGROUND: This case raises questions about the pathophysiology of muscle ruptures in highly functional patients with hereditary spastic paraplegia (HSP) who have only minor spasticity and no significant muscle shortening. Literature on the skeletal muscle changes secondary to spasticity or to the underlying disease, HSP, has been explored and compared with this clinical case. Two theoretical hypotheses are discussed. Firstly, chronic spasticity might be a risk factor for histopathological muscle alterations. Secondly, altered protein synthesis due to the underlying genetic mutation may play a role in the mechanical integrity of muscle tissue.
CASE REPORT: This is the first case report of a sequential bilateral complete disruption of the rectus femoris muscle after minimal trauma, in a 55 year old man with HSP. Pain was the main complaint, without significant increase in spasticity. Walking ability was not significantly impaired. Conservative treatment resulted in resolution of the complaints.
CLINICAL REHABILITATION IMPACT: This unique case of a bilateral complete rectus femoris muscle rupture after minimal trauma in a patient with HSP presenting with minor spasticity raises questions on the pathophysiology of the skeletal muscle changes in HSP patients and more generally in spastic patients.


KEY WORDS: Quadriceps muscle - Muscle spasticity - Muscle rupture - Hereditary spastic paraplegia - Case report

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