Acute Traumatic Avulsion of the Gluteus Medius Muscle in a Patient With no History of Hip Pain: A Case Report
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Published:
Oct 24, 2022
Keywords:
Hip, pain, gluteus, avulsion
Main Article Content
Abstract
Introduction: We report a clinical case of a woman with a complete acute avulsion of the gluteus medius muscle at its distal insertion in the greater trochanter, with an evolution of less than 24 hours from the onset of peritrochanteric pain and in the absence of a clear trigger or documented chronic degenerative wear. Anteroposterior (AP) pelvis and lateral hip radiographs were taken during her evaluation in the emergency department in view of the suspected diagnosis, with subsequent confirmation of the findings with magnetic resonance imaging (MRI). The patient was treated with a reconstructive surgical technique within the first week of the injury with excellent clinical and functional outcomes.
Conclusion: Acute traumatic avulsion of the gluteus medius muscle is a pathology with a low incidence, which means that the available evidence to guide its management is scarce. This clinical case is presented with the intention of exposing the clinical and diagnostic approach to this entity and showing a management option with satisfactory results.
Conclusion: Acute traumatic avulsion of the gluteus medius muscle is a pathology with a low incidence, which means that the available evidence to guide its management is scarce. This clinical case is presented with the intention of exposing the clinical and diagnostic approach to this entity and showing a management option with satisfactory results.
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How to Cite
Gómez Bermúdez, S. J., Quiroz Álvarez, J. E., Avendaño Arango, V., & Moore Velásquez, J. L. (2022). Acute Traumatic Avulsion of the Gluteus Medius Muscle in a Patient With no History of Hip Pain: A Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(5), 715-720. https://doi.org/10.15417/issn.1852-7434.2022.87.5.1552
Section
Case Presentations
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References
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5. Kagan A 2nd. Rotator cuff tears of the hip. Clin Orthop Relat Res 1999 Nov;(368):135-40. PMID: 10613161.
6. Bunker TD, Esler CN, Leach WJ. Rotator-cuff tear of the hip. J Bone Joint Surg Br 1997;79(4):618-20.
https://doi.org/10.1302/0301-620x.79b4.7033
7. Lerebours FR, Cohn R, Youm T. Endoscopic treatment of gluteus medius tears: A review. Bull Hosp Jt Dis
2016;74(1):58-62. PMID: 26977550
8. Godshaw B, Wong M, Ojard C, Williams G, Suri M, Jones D. Acute traumatic tear of the gluteus medius and
gluteus minimus in a marathon runner. Ochsner J 2019;19(4):405-9. https://doi.org/10.31486/toj.18.0090
9. Stanton MC, Maloney MD, Dehaven KE, Giordano BD. Acute traumatic tear of gluteus medius and minimus
tendons in a patient without antecedant peritrochanteric hip pain. Geriatr Orthop Surg Rehabil 2012;3(2):84-8.
https://doi.org/10.31486/toj.18.0090
10. Karpinski MR, Piggott H. Greater trochanteric pain syndrome. a report of 15 cases. J Bone Joint Surg Br
1985;67(5):762-3. https://doi.org/10.1302/0301-620X.67B5.4055877
11. Ilizaliturri VM Jr, Camacho-Galindo J, Evia Ramirez AN, Gonzalez Ibarra YL, McMillan S, Busconi BD. Soft
tissue pathology around the hip. Clin Sports Med 2011;30(2):391-415. https://doi.org/10.1016/j.csm.2010.12.009
12. LaPorte C, Vasaris M, Gossett L, Boykin R, Menge T. Gluteus medius tears of the hip: a comprehensive approach. Phys Sportsmed 2019;47(1):15-20. https://doi.org/10.1080/00913847.2018.1527172
13. Fisher DA, Almand JD, Watts MR. Operative repair of bilateral spontaneous gluteus medius and minimus tendon ruptures. A case report. J Bone Joint Surg Am 2007;89(5):1103-7. https://doi.org/10.2106/JBJS.F.01201
14. Whiteside LA. Surgical technique: Transfer of the anterior portion of the gluteus maximus muscle for abductor deficiency of the hip. Clin Orthop Relat Res 2012;470(2):503-10. https://doi.org/10.1007/s11999-011-1975-y
15. Chandrasekaran S, Lodhia P, Gui C, Vemula SP, Martin TJ, Domb BG. Outcomes of open versus endoscopic repair of abductor muscle tears of the hip: a systematic review. Arthroscopy 2015;31(10):2057-67.e2.
https://doi.org/10.1016/j.arthro.2015.03.042
16. Thaunat M, de Saint Vincent B, Caron E, Ingale PS. A Comparison of outcomes after endoscopic repair of partialversus full-thickness tears of the gluteus medius tendon. Arthroscopy 2021;37(8):2465-72.
https://doi.org/10.1016/j.arthro.2021.02.020
17. Nazal MR, Abraham PF, Conaway WK, Quinlan NJ, Gillinov SM, Gibbs JS, et al. Endoscopic repair of fullthickness gluteus medius and minimus tears-prospective study with a minimum 2-year follow-up. Arthroscopy 2020;36(8):2160-9. https://doi.org/10.1016/j.arthro.2020.04.025
18. Maldonado DR, Annin S, Chen JW, Yelton MJ, Shapira J, Rosinsky PJ, et al. Combined transfer of the gluteus
maximus and tensor fasciae latae for irreparable gluteus medius tear using contemporary techniques: short-term outcomes. JBJS Open Access 2020;5(4):e20.00085. https://doi.org/10.2106/JBJS.OA.20.00085
19. Vishwanathan K, Pathan SKA, Makadia RC, Chaudhary CB. Psychometric assessment of modified Harris hip score for femoral neck fracture in Indian population. Indian J Orthop 2020;54(Suppl 1):87-100.
https://doi.org/10.1007/s43465-020-00155-x
20. Walsh MJ, Walton JR, Walsh NA. Surgical repair of the gluteal tendons: A report of 72 cases. J Arthroplasty
2011;26(8):1514-9. https://doi.org/10.1016/j.arth.2011.03.004
40. https://doi.org/10.5435/JAAOS-D-14-00406
2. Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg 2009;108(5):1662-70. https://doi.org/10.1213/ane.0b013e31819d6562
3. Bird PA, Oakley SP, Shnier R, Kirkham BW. Prospective evaluation of magnetic resonance imaging and physical
examination findings in patients with greater trochanteric pain syndrome. Arthritis Rheum 2001;44(9):2138-45.
https://doi.org/10.1002/1529-0131(200109)44:9<2138:AID-ART367>3.0.CO;2-M
4. Kenanidis E, Kyriakopoulos G, Kaila R, Christofilopoulos P. Lesions of the abductors in the hip. EFORT Open Rev
2020;5(8):464-476. https://doi.org/10.1302/2058-5241.5.190094
5. Kagan A 2nd. Rotator cuff tears of the hip. Clin Orthop Relat Res 1999 Nov;(368):135-40. PMID: 10613161.
6. Bunker TD, Esler CN, Leach WJ. Rotator-cuff tear of the hip. J Bone Joint Surg Br 1997;79(4):618-20.
https://doi.org/10.1302/0301-620x.79b4.7033
7. Lerebours FR, Cohn R, Youm T. Endoscopic treatment of gluteus medius tears: A review. Bull Hosp Jt Dis
2016;74(1):58-62. PMID: 26977550
8. Godshaw B, Wong M, Ojard C, Williams G, Suri M, Jones D. Acute traumatic tear of the gluteus medius and
gluteus minimus in a marathon runner. Ochsner J 2019;19(4):405-9. https://doi.org/10.31486/toj.18.0090
9. Stanton MC, Maloney MD, Dehaven KE, Giordano BD. Acute traumatic tear of gluteus medius and minimus
tendons in a patient without antecedant peritrochanteric hip pain. Geriatr Orthop Surg Rehabil 2012;3(2):84-8.
https://doi.org/10.31486/toj.18.0090
10. Karpinski MR, Piggott H. Greater trochanteric pain syndrome. a report of 15 cases. J Bone Joint Surg Br
1985;67(5):762-3. https://doi.org/10.1302/0301-620X.67B5.4055877
11. Ilizaliturri VM Jr, Camacho-Galindo J, Evia Ramirez AN, Gonzalez Ibarra YL, McMillan S, Busconi BD. Soft
tissue pathology around the hip. Clin Sports Med 2011;30(2):391-415. https://doi.org/10.1016/j.csm.2010.12.009
12. LaPorte C, Vasaris M, Gossett L, Boykin R, Menge T. Gluteus medius tears of the hip: a comprehensive approach. Phys Sportsmed 2019;47(1):15-20. https://doi.org/10.1080/00913847.2018.1527172
13. Fisher DA, Almand JD, Watts MR. Operative repair of bilateral spontaneous gluteus medius and minimus tendon ruptures. A case report. J Bone Joint Surg Am 2007;89(5):1103-7. https://doi.org/10.2106/JBJS.F.01201
14. Whiteside LA. Surgical technique: Transfer of the anterior portion of the gluteus maximus muscle for abductor deficiency of the hip. Clin Orthop Relat Res 2012;470(2):503-10. https://doi.org/10.1007/s11999-011-1975-y
15. Chandrasekaran S, Lodhia P, Gui C, Vemula SP, Martin TJ, Domb BG. Outcomes of open versus endoscopic repair of abductor muscle tears of the hip: a systematic review. Arthroscopy 2015;31(10):2057-67.e2.
https://doi.org/10.1016/j.arthro.2015.03.042
16. Thaunat M, de Saint Vincent B, Caron E, Ingale PS. A Comparison of outcomes after endoscopic repair of partialversus full-thickness tears of the gluteus medius tendon. Arthroscopy 2021;37(8):2465-72.
https://doi.org/10.1016/j.arthro.2021.02.020
17. Nazal MR, Abraham PF, Conaway WK, Quinlan NJ, Gillinov SM, Gibbs JS, et al. Endoscopic repair of fullthickness gluteus medius and minimus tears-prospective study with a minimum 2-year follow-up. Arthroscopy 2020;36(8):2160-9. https://doi.org/10.1016/j.arthro.2020.04.025
18. Maldonado DR, Annin S, Chen JW, Yelton MJ, Shapira J, Rosinsky PJ, et al. Combined transfer of the gluteus
maximus and tensor fasciae latae for irreparable gluteus medius tear using contemporary techniques: short-term outcomes. JBJS Open Access 2020;5(4):e20.00085. https://doi.org/10.2106/JBJS.OA.20.00085
19. Vishwanathan K, Pathan SKA, Makadia RC, Chaudhary CB. Psychometric assessment of modified Harris hip score for femoral neck fracture in Indian population. Indian J Orthop 2020;54(Suppl 1):87-100.
https://doi.org/10.1007/s43465-020-00155-x
20. Walsh MJ, Walton JR, Walsh NA. Surgical repair of the gluteal tendons: A report of 72 cases. J Arthroplasty
2011;26(8):1514-9. https://doi.org/10.1016/j.arth.2011.03.004