Profound Calf Muscle Dysfunction following Hip Dislocation Monitored by Air Plethysmography

Abstract

Introduction

Calf muscle atrophy is commonly noted after lower-extremity immobilization. Air plethysmography (APG) provides an easily reproducible, noninvasive diagnostic test that is useful in measuring calf ejection fraction. Quantitative measurements can be preformed before and after physical therapy as a tool to evaluate effectiveness of treatment.

Method

We report the case of a 26-year-old woman who presented to the vascular surgery clinic with right lower extremity cyanosis, paresthesias, and swelling after hip dislocation. The patient had been immobile for a month. An arteriogram was performed to rule out arterial injury and a lower-extremity ultrasound was performed to rule out deep venous thrombosis and venous reflux. APG revealed a profoundly abnormal ejection fraction of 36%. Physical therapy was recommended, with special attention towards calf muscle strengthening.

Results

After 3 months of physical therapy, the APG ejection fraction increased to a normal value of 74%. In addition to normalization of the APG, all symptoms of cyanosis, paresthesias, and swelling were resolved.

Conclusion

APG may be a useful tool in measuring the restoration of calf muscle function in patients with injuries requiring extended immobilization.