Rupture tetiva srednjeg i najmanjeg glutealnog mišića

master's thesis

• Title (english): Gluteus medius and minimus tendon tears
• Author: Antonio Crnković
• Mentor: Ivan Bohaček (mentor)
• Committee member: Tomislav Smoljanović (predsjednik povjerenstva)
• Committee member: Zdravko Petanjek (član povjerenstva)
• Committee member: Ivan Bohaček (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anatomy and Clinical Anatomy); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Anatomy

Abstract

Srednji i najmanji glutealni mišić imaju važnu ulogu u stabilizaciji zdjelice tijekom hoda. Rupture tetiva tih mišića dovode do poremećaja u biomehanici hoda koji se prezentiraju antalgičnim šepanjem i lateralnom nestabilnošću zdjelice. Osim poremećaja biomehanike kuka, rupture tetiva srednjeg i najmanjeg glutealnog mišića pripadaju u uzroke sindroma bolnog velikog trohantera (eng. greater trochanteric pain syndrome) koji je karakteriziran kroničnom boli peritrohanterne regije. Usprkos postojanju brojnih stanja koja su povezana sa sindromom bolnog velikog trohantera, novija slikovna dijagnostika i kirurški nalazi pri zahvatima na zglobu kuka su otkrili rupture tetiva srednjeg i najmanjeg glutealnog mišića kao jedne od njegovih čestih uzroka. Same rupture često ostaju neprepoznate kao uzrok navedenog sindroma zbog njegove kompleksne diferencijalne dijagnoze. Jedan od vodećih uzroka njihove neprepoznatosti je slaba educiranost ortopeda i ostalih liječnika o rupturama tetiva srednjeg i najmanjeg glutealnog mišića. Cilj ovog rada je opisati kompleksnu regionalnu anatomiju zgloba kuka s posebnim osvrtom na srednji i najmanji glutealni mišić, sustav burza glutealnih mišića te funkciju i ulogu srednjeg i najmanjeg glutealnog mišića u biomehanici kuka. U radu će se navesti najnovija saznanja o etiologiji i epidemiologiji ruptura tetiva srednjeg i najmanjeg glutealnog mišića, a detaljan osvrt biti će na kliničku sliku samih ruptura te njihovo dijagnosticiranje i liječenje. Jedan od ciljeva ovog rada je i podizanje svijesti liječnika o postojanju navedene patologije.

Abstract (english)

Gluteus medius and gluteus minimus muscles play an important role in stabilization of the pelvis during gait. Ruptures of the gluteus minumus and medius tendons lead to disturbances in the gait biomechanics, which usually present as antalgic limping and lateral instability of the pelvis. Besides causing biomechanical disorders of the hip, they can also contribute to the development of a greater trochanteric pain syndrome, which is characterized by chronic pain present in the peritrochanteric region. Despite the fact that numerous conditions exist within the greater trochanter pain syndrome, new diagnostic imaging procedures and reported findings observed during hip surgery have detected gluteus medius and minimus rupture as one of its most frequent causes. Despite this fact, ruptures of gluteus medius and minimus tendons frequently remain unrecognized in practice as one of the causes of the greater trochanteric pain syndrome, probably due to complexity of its differential diagnosis. One of the leading causes of such low recognition rate may also be a lack of knowledge of orthopedic and other physicians about existence of ruptured tendons of gluteus medius and minimus as a pathological entity. The aim of this paper is to describe complex regional hip anatomy with special attention to the gluteus medius and minimus muscles, gluteal bursae and the function and role of gluteus medius and gluteus minimus in the biomechanics of the hip. Latest knowledge on etiology and epidemiology of gluteus medius and gluteus minimus tendon rupture will be outlined, together with a detailed review of the clinical manifestation of the ruptures and their diagnosis and treatment. One of the goals of this paper is to raise the physician's awareness of the existence of such pathology.

• Keywords: srednji glutealni mišić; najmanji glutealni mišić; ruptura; avulzija; sindrom bolnog velikog trohantera
• Keywords (english): gluteus medius; gluteus minimus; rupture; avulsion; greater trochanteric pain syndrome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:719063
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-16 13:53:20