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Tightness following flap surgery

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  • Tightness following flap surgery

    Approximately 10 years ago I had flap surgery for a left ischial wound. During recovery I was advised not to do ROM. Since then, my left hip (when doing knee to chest) is very tight, to the point of barely reaching 90 degrees. I had originally thought it might be HO, but it doesn't seem to be the case. Regardless, the tightness won't loosen up. Is it possible that when performing the flap surgery that the muscle was shortened to the extent that it would cause this?

  • #2
    Anyone?

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    • #3
      It is most likely that after ten years this contracture can't be stretched out. It is unfortunate, as it likely could and should have been stretched out as part of your post-flap sitting protocol. We prohibited flexion of the hip for 5 weeks after surgery, then over a week PT would gradually do flexion ROM, increasing the flexion daily until 90 degrees was achieved at both the hip and knee. This was done before sitting started at week 6.

      (KLD)
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      • #4
        Thank you for the explanation.

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        • #5
          Interesting update. On Friday, I had an xray of my abdomen done to check for a bowel blockage. After reviewing the first xray, the tech asked if I had broken my left hip before. I was somewhat startled, and responded that I wasn't aware if I had. She then said that maybe it was just bad arthritis then. Being concerned, I asked if it still looked broken, and she said no. Could it have actually been broken unknowingly, and still healed without any treatment? Does HO show up on an xray similarly?

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          • #6
            Yes, old matured HO may show up like a bone fracture callous on a plain Xray. Your physician may want to ask the radiologist to look at this closely (a tech cannot give you a diagnosis) and determine if it is most likely HO. HO can certainly be triggered by a pressure injury and/or flap surgery.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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