Inner Medial Femoral Trauma: Etiology and Treatment (CY Kong, 2009)

Inner Medial Femoral Trauma or Inner Thigh Trauma (ChiaYewnian Syndrome) was first described by Kong CY in 2009 in an isolated case involving a patient named Chi Ko Pek*, a 19 year old male . Chi Ko Pek presented with numbness of the inner thigh and distinct post traumatic stress disorder. After further inspection of the site of trauma and interview, it was found that Chi had presented with a disease that was never reported before in Medicine.







Etiology:







This trauma is humanovector borne. A humanovector in this case Ah Piang the Garang*, an 18 year old female, had inflicted trauma by touching the inner thighs of Ko with her phalanges. This disease will only manifest with cranial (upward) progression of phalangeal stimulus onto the medial inner thigh. Trauma is remarkably more marked if phalangeal stimulation proceeds to the pubic area. Humanovectors of Chiayewnian Syndrome have exhibited abnormally high amounts of oestradiol in females and testosterone in males and very pronounced levels of pheromone secretion. They however curiously are rarely sexually active. This an be explained by the fact that their celibacy actually drives them to out put any suppressed sexual needs to committing Inner Thigh Trauma. Inner Thigh Trauma has a higher incidence in females than males. Patients almost always are atrichomic (hairless) in the lower limb.







Diagnosis:







The signs and symptoms include the universal sign of embarassment- the obsessive adduction of the lower limbs. The adductor magnus muscles of the legs are in a contracted and stimulated state for a prolonged period of time. This can be considered biopsychosocial manifestation of the trauma to prevent further stimulation of the site and to protect from any more trauma. There is marked pathology of mindset in the patient, with vasodilatation especially in the facial area, indicating a sympathetic response (from stimulation by cervical outflow). There is marked numbness indicating sensory fatigue of touch receptors in the medial inner thigh. There is marked psychological trauma: post traumatic stress disorder has been reported in many such patients with Inner Thigh Trauma.







Treatment and Prevention:

The Adductor Magnus muscles



The best method of preventing such incidents are strengthening of the adductor magnus muscles of guys. Posture when sitting is also important. Sitting with legs closed (aductor magnus muscles contrated have shown to significantly reduce levels of Chiayewnian Syndrome.





When patients have exhibited symptoms, there is nothing much health care givers can do. It is as much a psychological disorder as it is a somatic pathology. The first thing to assess is as to the extent of the trauma. It is classified below





1 cm- 0 cm from pubic region: Highly SEVERE (needs immediate psychological intervention)





5 cm- 1cm from pubic region: SEVERE ( counselling)





More than 5 cm from pubic region : No intervention needed, surveillance recommended





Numbness in the leg usually subsides within a day while massage with deep heat on the adductor magnus muscles relieves it from contraction and promotes relaxation.





Stress medication should be prescribed if needed.

Published in the Peeamfourianic Journal of Medicine October 2009.

*All names have been changed in accordance with medical ethics.