[Chronic lumbago after unstable intertrochanteric femoral fracture: a new syndrome or sporadic feature of hip biomechanics after surgery? A case report].
OBJECTIVE
Only in 2002, more than 86,000 hip fractures were registered in Italy in male and female patients over 45 years old, with 9% progression compared to 1999. In this paper, we report a clinic case of a patient experiencing working problems for a chronic back pain after an unstable extracapsular hip fracture.


METHODS
The patient, a 54 years old woman, factory worker, complaining of low back pain weeks after the hip fracture, was evaluated and scheduled for a computer tomography examination of the lumbar spine. The C.T. scans were evaluated to assess eventual evidence of disc problems and/or cross sectional changes in density and fibro-adipose degeneration of muscular body of the psoas muscle.


RESULTS
Because back pain matched with the evidence of cross sectional changes in psoas density without any evidence of disc herniation, the patient was scheduled for aspecific back pain training. After a specific rehabilitation protocol the patient had 75% pain relief after four weeks.


CONCLUSIONS
Age and diseases related changes are commonly seen in the lumbar spine, but the relationship between these changes and symptoms of back pain is not straightforward. Our case report suggest that back pain following extra capsular hip fracture may involve the psoas muscle. The prognosis might be favourable following a specific back training that is actually object of an ongoing controlled trial.
Di Lorenzo
L
L
U.O. Riabilitazione & Centro di Terapia del Dolore Ospedale DEA II G. Rummo, Benevento, Italy. luigidilorenzo2005@libero.it
Forte
A
A
Landolfi
A
A
Di Mario
M
M
Formisano
R
R
Gatto
S
S
D001696:Biomechanical Phenomena; D002908:Chronic Disease; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D008875:Middle Aged; D011379:Prognosis; D016658:Psoas Muscles / Q000473:pathology*; D013577:Syndrome; D016896:Treatment Outcome