Lombalgie cronica invalidante dopo frattura intertrocanterica instabile di femore: Nuova sindrome o sporadica alterazione biomeccanica dell'anca dopo la chirurgia? 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. Subject and Method: The 54th lady patient, workers in a factory, complaining low back pain weeks after the hip fracture were evaluated and scheduled for a Computer Tomography examination of the lumbar spine. The CT. scans performed were evaluated to assess eventual evidence of discal problems and/or cross sectional changes in density and fibro-adipous degeneration of muscular body of Psoas muscle. Result: Because back pain matched with the evidence of cross sectional changes in psoas density without any evidence of discal erniation, the patient was scheduled for aspecific back pain training. After a specific rehabilitation protocol the patient achieved a 75% of pain relief after four weeks. Conclusion: 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.