Schäfer B, Bahm J, Beier J P
Department for Plastic Surgery, Hand Surgery-Burn Center, Division for Plexus Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, 52074 North Rhine-Westphalia, Germany.
JPRAS Open. 2025 Aug 8;45:460-465. doi: 10.1016/j.jpra.2025.08.003. eCollection 2025 Sep.
We present the case of a physically active 50-year-old patient who underwent an arthroscopic release of the iliopsoas tendon due to a snapping hip. Postoperatively, active hip flexion was severely weakened. As a consequence patient had no stable gait pattern and was unable to continue her sports and physical activities. An MRI scan revealed an atrophy of the iliopsoas muscle. We reconstructed the patient's hip flexion function using a free functional muscle transfer of the ipsilateral gracilis muscle. After reinnervation of the microsurgically transferred gracilis muscle, the patient developed a strong hip flexion again, so that her gait pattern returned to normal and she was able to do strength training and ride a bicycle again. This case shows a very rare but serious complication of the frequently performed iliopsoas release. Functional reconstructions of hip flexion have only been described in single cases. To our knowledge, no case of free functional muscle transfer for the reconstruction of the hip flexion has been described in the literature. We can present a successful complex method for active reconstruction.
我们报告一例50岁身体活跃的患者，因弹响髋接受了髂腰肌肌腱关节镜松解术。术后，主动髋关节屈曲严重减弱。结果，患者没有稳定的步态模式，无法继续她的运动和体育活动。磁共振成像扫描显示髂腰肌萎缩。我们使用同侧股薄肌游离功能性肌肉转移重建了患者的髋关节屈曲功能。在显微外科转移的股薄肌重新获得神经支配后，患者再次出现强大的髋关节屈曲，步态模式恢复正常，她能够再次进行力量训练和骑自行车。该病例显示了常见的髂腰肌松解术一种非常罕见但严重的并发症。髋关节屈曲的功能重建仅在个别病例中有描述。据我们所知，文献中尚未描述用于重建髋关节屈曲的游离功能性肌肉转移病例。我们可以展示一种成功的主动重建复杂方法。
