Femoral Nerve Injury Due to an Open Subtrochanteric Hip Fracture – The Importance of Early Detection and Implication for Rehabilitation

Abstract

Purpose: Here we present the unusual case report of where a woman sustained a traumatic injury causing an open right subtrochanteric hip fracture which damaged the femoral nerve. Case Report: A 39-year old woman presented with an open right subtrochanteric hip fracture following an accident at work where a large heavy pallet fell onto her causing both hips to hyperextend. She sustained 10 cm transverse wound near the groin crease and the proximal end of the shaft of the femur was visible in the wound. Initial neurological examination was limited by the fracture and associated pain but it was noted that she had decreased sensation to light touch in the distribution of the femoral nerve. She was taken to theatre that day and underwent debridement with exploration of the right groin and fracture fixation with a femoral nail. She recovered well post-operatively though was noted to have patchy numbness over the leg in a non-dermatomal pattern. Subsequent EMG examination demonstrated a near complete lesion to the right femoral nerve to quadriceps. She continued physiotherapy and gradually improved but three years after the injury she still struggles with her gait because of reduced hip flexion power and restricted knee flexion.