Gait performance in an original biologic reconstruction of proximal femur in a skeletally immature child: a case report

Changes of gait characteristics in a child with femoral nerve injury: a 16-month follow-up case study

An 11-year-old child was able to walk independently even though he had injured his femoral nerve severely due to a penetrating wound in the medial thigh. In this study, gait analysis was conducted five times totally for 16 months to observe the characteristics of the gait parameters, which enabled him to walk independently. The cadence, walking speed, stride length, step length, stride time, step time, double limb support, and single limb support all improved after the third test (GA3). Insufficient knee flexion during the stance phase, that was the main problem of the subject, improved from 0.96° to the normal level of 17.01°. Although hip extension was also insufficient at the first test it subsequently improved and reached the normal range at the GA5. The peaks of the ground reaction force curve were low at the initial tests. However, these eventually improved and reached the reference values. The knee extensor moment during the stance phase increased markedly at the last test. Although the child lost his femoral nerve function, he was able to walk independently by compensating for the major function of the rectus femoris. In order to facilitate shock-absorption and move the feet forward, he reduced both gait speed and stride length, respectively. The results of this study are expected to provide insight into how clinicians set up their therapy goals, while considering compensations and changes over time.