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Lower Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Malynda Williams
Acknowledging the variable relationships between gluteus medius, gluteus minimus, and vastus lateralis and the potential independent insertions of these muscles onto the greater trochanter is important for successful hip operations, particularly when using the transgluteal approach (Heimkes et al. 1992).
Hip and knee
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Palpate all around the hip joint line for any areas of tenderness. Tenderness in specific areas may relate to an underlying pathology: greater trochanter (trochanteric bursitis)lesser trochanter (common with sporting injuries to iliopsoas)ischial tuberosity (common with sporting injuries to hamstring muscles.)
Surgery of the Hip
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Daud TS Chou, Jonathan Miles, John Skinner
The gluteus medius and minimus complex is left attached to the greater trochanter and their anterior and posterior borders defined carefully. An oscillating saw is used to create an osteotomy, separating the greater trochanter from the proximal femur. The abductors, proximally and vastus lateralis distally, remain attached to the greater trochanter. The greater trochanter and abductor complex are reflected upwards; this may require some dissection of the undersurface of the abductors away from the superior capsule.
Greater trochanteric pain syndrome: predicting who will respond to a local glucocorticoid injection
Published in Scandinavian Journal of Rheumatology, 2021
M Jarlborg, DS Courvoisier, A Faundez, L Brulhart, A Finckh, MJ Nissen, S Genevay
Despite its high prevalence and morbidity, GTPS is often poorly recognized and underdiagnosed. This syndrome is mainly defined as pain and tenderness in the region of the greater trochanter, which may radiate down to the posterolateral aspect of the thigh (11). The FABER (or Patrick’s) test, when associated with LHP, has been shown to differentiate GTPS from hip osteoarthritis (11). The 30-second single-leg stance test and the resisted external derotation test (Lequesne test) are good indicators for tendinous lesions and bursitis in GTPS (12–14). The Trendelenburg test is used for the detection of gluteus medius tears (15). There are currently no clear diagnostic criteria, nor consensus on management. Glucocorticoid (GC) injection is often used for treatment (16, 17); however, the clinical benefit is short term at best (17) and may not be superior to dry needling at 6 weeks (18). The benefit of ultrasound-guided injection remains also controversial (19). Local GC injections are not without risk, including damage to tendinous structures, increased tenocyte senescence (20), and a plethora of GC-related side-effects (21, 22). Therefore, it would be valuable for clinicians to be able to identify a subgroup of patients more likely to respond to a GC injection.
Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes
Published in Physiotherapy Theory and Practice, 2019
Suzana C Almeida, Steven Z George, Raquel D. V Leite, Anamaria S Oliveira, Thais C Chaves
The points evaluated by algometry were the thenar region of the nondominant hand and the nine sites described by the American College of Rheumatology (Wolfe et al., 1990), including the following: 1) sternal border of the sternocleidomastoid muscle above the head of the clavicle; 2) midpoint of the upper trapezius muscle; 3) second rib, lateral to the costochondral junction, on the upper surface (request contraction of the pectoralis major); 4) 2–4 cm distal to the lateral epicondyle (m. brachioradialis); 5) medial knee fat, proximal to the joint interline; 6) insertion of the suboccipital muscle; 7) supraspinatus insertion above the spine of the scapula, near the upper edge; 8) superolateral quadrant of the buttock, anterior to the muscle (contraction of the gluteus maximus); and 9) posterior to the greater trochanter.
Equivalent hip stem fixation by Hi-Fatigue G and Palacos R + G bone cement: a randomized radiostereometric controlled trial of 52 patients with 2 years’ follow-up
Published in Acta Orthopaedica, 2019
Peter B Jørgensen, Martin Lamm, Kjeld Søballe, Maiken Stilling
Patients assessed for study participation and follow-up of randomized participants are shown in the CONSORT flowchart (Figure 1). 1 patient was excluded during surgery because the MixiGun jammed twice during application of cement, due to a human error. At 2 years’ follow-up, there have been no revisions due to aseptic implant loosening. 1 patient suffered a traumatic periprosthetic fracture 18 months after operation and received revision of the stem and osteosynthesis of the fracture. 2 patients suffered hip dislocation within the first 3 months, 1 of these combined with avulsion of the greater trochanter. Another patient had avulsion of the greater trochanter post-surgery without known trauma. Both avulsions were treated nonoperatively. There was 1 periprosthetic infection 1 month postoperatively treated with soft tissue debridement and change of acetabular liner and metal head. This patient had a full recovery but died of causes unrelated to the periprosthetic infection 2 months before 2-year follow-up. The clinical scores (OHS and VAS pain) were similar at 1-year follow-up and 2-year follow-up between groups (Figure 2). At 2-year follow-up, VAS pain and OHS correlated neither with subsidence (rho < 0.2) nor with retroversion (rho < 0.01) (Table 2, see Supplementary data).