Pattern of Innervation of the Upper Gluteus Maximus Muscle: Implication in Prosthetic Hip Dislocation

Awori K.O. MBChB, MMed (Surgery), Dip. (SICOT), FCS (Orth) ECSA, Anne N. Pulei A.A. Bsc, MBChB, Gikenye G. MBChB, MMed,FCS(ECSA) Affi liation: Department of Human Anatomy, University of Nairobi, P.O. Box 30197 00100 Nairobi, Kenya. Corresponding author: Kirsteen O. Awori, Tel. 254-722812499, Email:

Abstract

Background: Dislocation is one of the most common complications after total hip arthroplasty. The posterolateral approach avoids disruption of the abductor mechanism but may denervate gluteus maximus as a basis for associated higher dislocation rates.

Objective: To determine the pattern of innervation of gluteus maximus

Study design: Descriptive cross-sectional study

 

Materials and methods: Twenty four cadavers for routine dissection in the Department of Human Anatomy, University of Nairobi were used. Having exposed the gluteus maximus, the muscle was transected close to its distal attachment and reflected superiorly to expose the entry of the neurovascular structures into it from the greater sciatic foramen. The pattern of distribution of the inferior gluteal nerve to the muscle was noted and the left and right in the same cadaver compared

 

Results: In all the 48 cadaver sides, the inferior gluteal nerve exited the pelvis via the infra-piriformic compartment of the greater sciatic foramen. In majority (43, 89.6%) of gluteal regions this nerve funned out in multiple equal branches to the GM. Only one branch crossed the upper border of piriformis muscle. In 5 cases, this single branch that crossed the upper border of piriformis was a major trunk almost equal in size to the parent nerve. One such case was bilateral.

Conclusion: A major branch of the inferior gluteal nerve to the upper part of GM, when present, could be injured in the posterior approaches to the hip to significantly weaken the upper part of this muscle increasing the risk of prosthetic hip dislocation.

 

ssk_logo.png

The Annals of African Surgery is the official publication of the Surgical Society of Kenya.

 

All content copyright © 2020 Annals of African Surgery.

ISSN (print): 1999-9674; ISSN (online): 2523-0816

Main Office Location: Menelik Medical Centre, Menelik Road, off Ngong Road, Nairobi. First floor.

Telephone: +254715260499

Email: info@annalsofafricansurgery.com.

 

The content on this site is intended for health professionals. Advertisements on this site do not constitute a guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer.

70.png
69.jpg
hinari_header_en.png
  • Twitter
  • Facebook Social Icon
  • LinkedIn