Abstract

ALVES, Ricardo et al. Transferência do grande glúteo para correcção da deficiência dos abdutores da anca: caso clínico. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.3, pp.213-221. ISSN 1646-2122.

Hip abductors pathology is fairly common, having as symptoms pain in the trochanteric region and positive clinical tests. It may even be associated with hip instability in patients previously submitted to a total hip replacement. The use of magnetic resonance (MRI) to study this pathology revealed a series of unknown changes and the images obtained with the MRI allowed the description of a classification for the ruptures of gluteus medius, published by the Milwaukee group. We describe the case of a patient with history of congenital hip dislocation, submitted to multiple surgeries to correct this pathology and finally had to do a total hip replacement. After this last procedure she developed serious hip abductors deficiency, reason why she had to be operated. We preceded to the transfer of the gluteus magnus, accordingly to a variation of the Whiteside technique. Gluteus medius avulsion is the most serious lesion of this muscle. The direct external approach in a total hip arthroplasty is associated to a bigger percentage of cases of gluteus medius insufficiency. However, late direct repair of this muscle lesion is associated to low satisfactory results. So, a various number of techniques are describes, which allow for the reconstruction of the hip abductors. The technique published by Whiteside is one of them. It is also one of which presents better results, being the authors method of choice to deal with cases in which chronic hip abductors avulsion is present.

Keywords : Hip abductors; trochanteric pain; gluteus medius avulsion; Whiteside technique.

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