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Blocks of Nerves of the Sacral Plexus Supplying the Lower Extremities
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
A technique for blocking the nerve to the quadratus femoris muscle has been described as an alternative to surgical nerve section in adult patients with severe osteoarthritic pain of the hip.35–37 This technique consists of inserting a needle posteriorly to the greater trochanter, with the patient lying prone. The needle is advanced towards the junction of the middle with the lower third of a line extending from the sacral hiatus to the posterior superior iliac spine. This technique is not free of complications and requires as much local anesthetic as a complete sciatic nerve block. As it is of no interest in pediatric anesthesia, it will not be further discussed.
Sugioka's transtrochanteric anterior rotational osteotomy
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Thereafter, the hip joint capsule is incised circumferentially while carefully protecting the posterior branch of the medial circumflex artery, which is located at the inferior edge of the quadratus femoris. Two pins are placed laterally to medially in the greater trochanter in a plane perpendicular to the femoral neck. Then, a transtrochanteric osteotomy is made, followed by a second osteotomy at right angles to the first osteotomy, roughly at the superior edge of the lesser trochanter such that the greater trochanter is left with the distal fragment (Figure 23.2).
Advances in Hip Arthroscopy
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Also known as deep gluteal pain, piriformis syndrome is a pathological condition diagnosed by ruling out other causes and is hypothesised to be due to muscle spasms or compression by piriform muscle, fibrous bands, vascular malformations and adherences to the obturator muscles and the quadratus femoris muscle. It manifests as pain in the gluteal region, with or without accompanying sciatic pain. It worsens with local deep pressure and generally continues for years.
Imaging changes following surgery for ischiofemoral impingement
Published in Baylor University Medical Center Proceedings, 2023
Munif Hatem, Richard Feng, Jordan Teel, Hal David Martin
All surgical procedures were performed by the same surgeon. Patients were positioned supine on a traction table with 20° of contralateral tilt. Patients with positive intraarticular injection test preoperatively underwent intraarticular assessment and associated procedures. The LT plasty was performed endoscopically through a posterolateral approach.3 Three portals were utilized: anterolateral, auxiliary proximal, and auxiliary distal (Figure 2). The LT was reached through a window in the quadratus femoris muscle between the medial femoral circumflex artery and first perforating branch of the profunda femoris artery (Figure 3). The amount of LT to be resected was determined according to the preoperative ischiofemoral space measured on the MRI with controlled positioning of the lower limbs. The observation of hard impingement bone was also utilized as an intraoperative guide for the LT plasty.
Hip physical examination extension loss and radiographic osseous findings in patients with low back pain and nonarthritic hips
Published in Baylor University Medical Center Proceedings, 2022
Richard Feng, Munif Hatem, Scott J. Nimmons, Ashley Disantis, RobRoy L. Martin, Hal David Martin
All MRI studies were performed with the patient in a supine position. Two patients had neurostimulators implanted in their low back, and the assessments were performed utilizing computed tomography. Acetabular version and femoral torsion were assessed on axial images obtained with the patient supine and the feet taped midfoot stance position.17 The acetabular version was measured in the axial cut at the greatest distance between the anterior and posterior acetabular walls.18 Femoral torsion measurements were assessed using the posterior surface of the femoral condyles at the knee as the distal reference and the femoral neck axis in the first axial cut distal to the femoral head as the proximal reference19(Figure 3). The McKibbin index was determined by adding the acetabular version to the femoral torsion.18 Ischiofemoral distance and quadratus femoris space were measured according to Torriani et al20(Figure 4).
Effect of dry needling on myofascial pain syndrome of the quadratus femoris: A case report
Published in Physiotherapy Theory and Practice, 2018
The hip muscles, apart from performing important local functions, influence and are also being influenced by the distal joints such as the knee (Reiman et al. 2009). Hip MTrPs are found to be associated with decreased muscle strength in patients with knee pain (Roach et al. 2013). The deep hip external rotators function like the rotator cuff of the shoulder and contribute to dynamic stability of the hip joint (Yoo et al. 2015). Interventions for improving their strength are becoming an important component of rehabilitation protocols (Bennell et al, 2014). The quadratus femoris (QF) forms an essential part of the deep hip external rotators and its dysfunction has recently been implicated as an important source of hip pain (Kassarjian et al. 2011) (Figure 1).