Publication date: March 2020
Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 3
Author(s): Kengo Kawanishi, Shintarou Kudo, Katsushi Yokoi
Abstract
Objective
To investigate the association between gliding and lateral femoral pain with trochanteric fracture (TF).
Design
Prospective cohort study.
Setting
The survey was conducted at approximately 3 weeks and 11 weeks post operation.
Participants
Patients (N=23) with TF after surgery.
Interventions
Not applicable.
Main Outcome Measure
Pain was assessed using a numeric rating scale for the following 5 conditions: rest pain, tenderness pain, stretch pain (SP), contraction pain, and weight-loading pain. Based on weight-loading pain, the subjects were divided into 2 groups: severe and moderate. Gliding of both the vastus lateralis (VL) muscle and subcutaneous (SC) tissue were recorded during knee motion using B-mode ultrasonography with a 12-MHz linear transducer fixed on the lateral thigh using an original fixation device. Particle image velocimetry analysis software was adapted to create the flow velocity of both VL muscle and SC tissue from echo imaging, and 2 regions of interest were selected on the VL muscle and SC tissue. Gliding was calculated using a coefficient of correlation from each time series data set.
Results
Gliding and pain (stretch/contraction) were significantly different between the 2 groups at 3 weeks post operation. Changes in both weight-loading pain (r=0.49) and SP (r=0.42) correlated significantly with improvements in gliding.
Conclusion
Patients with weight-loading pain after surgery for TF showed decreased gliding during recovery, and an improvement in gliding was associated with improvements in both weight-loading pain and SP.
Graphical abstract
We examined the association between tissues gliding and lateral femoral pain using a Particle Image Velocimetry assay. An improvement in gliding correlates with an improvement in postoperative pain (Load pain/Stretch pain) with trochanteric fracture. Gliding is an important factor in lateral femoral pain after trochanteric fracture.
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