Trendelenburg gait
| Trendelenburg gait | |
|---|---|
| Other names | Gluteus medius lurch |
| Specialty | Neurology |
Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal gait. It is caused by weakness or ineffective action of the gluteus medius muscle and the gluteus minimus muscle.
Gandbhir and Rayi point out that the biomechanical action involved comprises a Class 3 lever, where the lower limb's weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the antero-lateral surface of the greater trochanter of the femur, provide the effort.[1][relevant?] The causes can thus be categorized systematically as failures of this lever system at various points.[citation needed]
Signs and symptoms
During the
When standing on the right leg, if the left hip drops, it is a positive right Trendelenburg sign (the opposite side drops because the hip abductors on the right side do not stabilize the pelvis to prevent the droop). When the patient walks, if he swings his body to the right to compensate for left hip drop, he will present with a compensated Trendelenburg gait.[2] The patient exhibits an excessive lean in which the upper body is thrust to the right to keep the center of gravity over the stance leg.[2]
Causes
Trendelenburg gait is caused by weakness or ineffective action of the
- Damage to the motor nerve supply of the lateral gluteal muscles (gluteus medius muscle and gluteus minimus muscle)
- L5 (foot drop may also be seen because L5 innervates the tibialis anterior muscle).[4]
- Damage to the superior gluteal nerve.
- Temporary or permanent weakness of the lateral glutei
- Tendinitis.
- Penetrating injury.
- Infection, abscess – blood borne, post-traumatic or post-surgical.
- Ineffective action (insufficient leverage) of the lateral glutei
- Greater trochanteric avulsion.
- Fracture, (or non-union) of the femoral neck.
- Coxa Vara (the angle between the femoral neck head and shaft is less than 120 degrees).
- Damage to the hip joint (fulcrum) - Chronic or Developmental Hip Dislocation/Dysplasia
- Osteonecrosis.
- Legg-Calve-Perthes disease.
- Developmental dysplasia.
- Chronic infection.
- Uncorrected traumatic dislocation.
Treatment
Treatment is directed at the underlying cause. In addition, biofeedback and physical therapy are used to strengthen the muscles.[5]
History
Trendelenburg gait was first described by Friedrich Trendelenburg in 1895.[4]
See also
References
- PMID 31082138, retrieved 2021-02-27
- ^ a b "Gait Analysis". Retrieved 6 May 2012.
- ISBN 978-1-4377-2207-9, retrieved 2021-02-27
- ^ ISBN 978-0-323-06504-7, retrieved 2021-02-27
- S2CID 5864609. Archived from the originalon 2013-02-12.
- Wheeless' textbook of orthopaedics [1]
- Ropper and Brown, Adams and Victor's Principles of Neurology, 8th edition (2005), p. 105
External links