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Hypertensive Encephalopathy: Rare Complication After Orthopedic Manipulation

MOHAMED K. MARDINI, MD, FAAP, FACC; MUHAMMAD A. MIKATI, MD; ROBERT LIFESO, MD, FRCS(C)
Am J Dis Child. 1982;136(12):1092-1094. doi:10.1001/archpedi.1982.03970480058014.
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Mild and transient hypertension is not an infrequent complication in children after orthopedic immobilization and surgical correction of flexion contractures of both the hip and knee joints.1-5 However, hypertensive encephalopathy rarely occurs in such patients.2,3,6,7 We describe a 4-year-old boy in whom hypertensive encephalopathy developed after surgical correction of fixed flexion contracture of the left hip and knee joints. To our knowledge, only one similar case has been reported.3 Despite its rarity, the serious clinical implications of this condition warrant the attention of physicians.

Report of a Case.—A 4-year-old boy was admitted to the King Faisal Specialist Hospital, Riyadh, Saudi Arabia, for release of left hip and knee contractures resulting from poliomyelitis that occurred at the age of 2 years. With the exception of being small for his age and having 90°-fixed contractures of the left hip and knee, results of his admission examination were normal;

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