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“I walk funny and I don’t know why,” Osteopathic manipulative treatment for an adult female with congenital bilateral Femoral Neck Anteversion (FNA)

Journal: The AAO Journal Date: 2024/06, 34(2):Pages: 19-20. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

case report [705]
female [594]
femoral neck anteversion [1]
OMT [3746]
osteopathic manipulative treatment [3766]
thigh [3]
women [550]

Abstract:

Introduction/Background: Femoral neck anteversion (FNA) is a structural condition whereby the femoral neck is internally rotated, causing genu valgus and in-toeing of the feet. It is influenced by genetic predisposition and in-utero positioning, and is more common in females. Most cases self-resolve as children age, however a small percentage persist through adulthood with varying degrees of severity. Case: This case follows a 26-year-old female with several years of hip pain and low back pain secondary to bilateral FNA. Her FNA caused limitations in her ability to walk, run, stand, and exercise, as well as insecurities about her posture and gait. Osteopathic Manipulative Treatment (OMT) targeted at the patient’s pelvis, sacrum, and surrounding hypertonic muscles was used to correct compensatory somatic dysfunctions which developed in relation to her FNA. Results: This patient received 3 treatments of OMT over a 10-week period and reported a 60% decrease in her pain from the first to the second visit, with her pain being mostly resolved by the third visit. She was able to increase the duration and frequency of her exercise, as well as enjoy activities that require long periods of walking or standing, without pain. Future treatment and home stretches were advised to maintain these results and treat additional somatic dysfunctions that may occur with her FNA. Discussion: Untreated FNA can lead to chronic low back, hip, and knee pain, and osteoarthritis in adulthood. The standard treatment for FNA in adults at this time is derotational femoral osteotomy (DFO), used mainly for severe cases. This study highlights an alternative and preventative treatment option for patients with FNA. Further research is warranted at how OMT could be used for patients seeking surgical alternatives.


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