{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:09:51Z","timestamp":1774444191208,"version":"3.50.1"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Quadriceps contracture, characterized by the shortening of the quadriceps muscle and reduced knee flexion, poses challenges in daily activities. The etiology of this condition includes congenital, traumatic, infective, or iatrogenic factors.Treatment typically involves surgical intervention, with various techniques described in the literature. Differentiating between isolated rectus femoris contracture and combined rectus and quadriceps contractures is crucial for appropriate management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 14-year-old female presented with gait disturbance and limitations in sitting and squatting due to rectus femoris contracture secondary to repetitive intramuscular injections. Physical examination revealed restricted knee flexion and positive Ely's test. The patient underwent rectus femoris lengthening (RFL) surgery, resulting in improved knee flexion and hip extension. Postoperatively, early mobilization and physiotherapy were initiated, leading to complete recovery with no complications during a three-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Quadriceps femoris muscle contracture in childhood can result from congenital factors or acquired causes such as injections, trauma, infections, or ischemia. In Syria, injection-induced contractures are prevalent due to widespread intramuscular drug administration. Differentiating between isolated rectus femoris contracture and combined quadriceps contracture is crucial for treatment selection. Surgical intervention, such as rectus femoris lengthening using the Z-plasty procedure, yields favorable outcomes. Postoperative physiotherapy is essential. Incision necrosis is a common complication, mitigated by careful incision placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Injection-induced rectus femoris contracture is common in children due to repeated thigh injections. Healthcare providers should consider alternative administration sites and routes to prevent contractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.109835","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T02:07:05Z","timestamp":1717121225000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Surgical treatment of injection-induced rectus femoris muscle contracture in a child: A case report"],"prefix":"10.1097","volume":"120","author":[{"given":"Qusai","family":"Razzouk","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Al-mahdi","family":"Al-kurdi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Diab","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Khair","family":"Kajjan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Alloush","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Aleppo University Hospital, Aleppo, Syrian Arab Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"1","key":"R3-57-20260325","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1302\/0301-620X.67B1.3968154","article-title":"Injection-induced contractures of the quadriceps in childhood. A comparison of proximal release and distal quadricepsplasty.","volume":"67","author":"Jackson","year":"1985","journal-title":"J Bone Joint Surg Br [Internet]."},{"issue":"1","key":"R4-57-20260325","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3928\/0147-7447-20040101-22","article-title":"Injection-induced contracture of the quadriceps femoris muscle in children","volume":"27","author":"Milcan,","year":"2004","journal-title":"Orthopedics"},{"issue":"7","key":"R5-57-20260325","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.otsr.2013.04.014","article-title":"Distal quadricepsplasty in children: 88 cases of retractile fibrosis following intramuscular injections treated in Benin","volume":"99","author":"Fiogbe,","year":"2013","journal-title":"Orthop. Traumatol. Surg. Res."},{"issue":"5","key":"R6-57-20260325","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi,","year":"2023","journal-title":"Int. J. Surg."},{"key":"R7-57-20260325","first-page":"102","article-title":"Proximal release for injections induced hip flexion contracture in a child: a case report","volume":"1","author":"Diri,","year":"2023","journal-title":"Int. J. Surg. Case Rep."},{"key":"R8-57-20260325","article-title":"Results of surgical treatment of quadriceps femoris\/ contracture in children","volume":"3","author":"Muteti,","year":"2009","journal-title":"East African Orthopaedic Journal EAOJ."},{"key":"R9-57-20260325","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.cvsm.2005.05.008","article-title":"Healing, Diagnosis, Repair, and Rehabilitation of Tendon Conditions. 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