The Nerve to Quadratus Femoris

Abstract Objective: To determine the size of the ischiofemoral space (IFS) and quadratus femoris space (QFS) in patients with and without ischiofemoral impingement (IFI). Materials and Methods: Case-control study including consecutive patients submitted to magnetic resonance imaging (MRI) of the hip joint during a three-month period. Patients with deep gluteal pain who tested positive for IFI on at least one clinical test and showed signal changes in the quadratus femoris muscle on MRI were categorized as having a confirmed diagnosis of IFI. Results: Final sample comprised 50 patients submitted to unilateral MRI of the hip joint. The mean age was 47.3 ± 14.0 years (range, 22-76 years), and 33 (66%) of the patients were women. A diagnosis of IFI was made in 6 patients (12%), all of whom were female. On average, IFS and QFS were significantly smaller in IFI group than in control group (11.1 ± 2.7 mm versus 27.5 ± 6.5 mm and 5.3 ± 1.8 mm versus 18.8 ± 4.8 mm, respectively; p < 0.001 for both). Conclusion: Results of specific clinical tests and MRI findings indicate that the IFS and QFS are significantly reduced in patients with IFI.

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Results of quadratus femoris muscle pedicle bone grafting (Meyers’ procedure) in the management of ununited femoral neck fractures

Hip International ◽

10.1177/1120700020918851 ◽

2020 ◽

pp. 112070002091885

Author(s):

Harun Yasin Tüzün ◽

Selim Türkkan ◽

Ömer Erşen ◽

Arsen Arsenishvili ◽

Mustafa Kürklü

Keyword(s):

Femoral Neck ◽

Young Patients ◽

Functional Results ◽

Femoral Neck Fractures ◽

Posterior Cortex ◽

Complication Risk ◽

Length Width ◽

Femoris Muscle ◽

Quadratus Femoris

Purpose: Femoral neck fractures in young patients are associated with increase complication risk. The objective of this study was to evaluate the results of quadratus femoris muscle pedicle grafting in the treatment of ununited femoral neck fractures. Methods: This study includes 16 patients with ununited femoral neck fractures treated with quadratus femoris muscle pedicle graft. 7 patients had neglected femoral neck fractures while 9 had ununited femoral neck fractures after fixation. Quadratus femoris muscle with 2 × 1 × 1 cm (length-width-height) bone in its insertion was elevated and placed in the posterior cortex of the femoral neck with additional cancellous graft from the posterior iliac bone. The graft was fixed with 3.5-mm cortical screws. Results: The average follow-up period was 96 weeks and the radiological union occurred at an average of 7 months. The femoral inclination of all patients was 128.5° ± 3.9° with an average 7 (range 0–35) mm thigh atrophy in the last follow-up visit. Only 1 patient (6%) had avascular necrosis of the femoral head and was treated with hip arthroplasty. Conclusions: Quadratus femoris muscle pedicle grafting provides better stability and blood supply in ununited femoral neck fractures. Achieving fracture union provides better clinical and functional results in the treatment of femoral neck fractures.

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A Case Report of Nocardiosis Occurring in the Quadratus Femoris Muscle.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.40.1767 ◽

1992 ◽

Vol 40 (4) ◽

pp. 1767-1769 ◽

Cited By ~ 1

Author(s):

Akira Iwaki ◽

Masahiro Ushijima ◽

Tatsumi Nakamura ◽

Kazuhide Uenoyama ◽

Masaaki Morooka

Keyword(s):

Case Report ◽

Femoris Muscle ◽

Quadratus Femoris

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Evaluation of Ishiofemoral Space and Quadratus Femoris Space by Magnetic Resonance Imaging

Van Medical Journal ◽

10.5505/vtd.2019.75318 ◽

2019 ◽

Vol 26 (4) ◽

pp. 475-478

Author(s):

Kutsi Tuncer ◽

Gökhan Polat ◽

Adem Karaman ◽

Sinan Yılar ◽

Fatih Alper

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Quadratus Femoris

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Quadratus Femoris Partial Tear Secondary to Occult Ischiofemoral Impingement

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i09.2392 ◽

2021 ◽

Vol 11 (9) ◽

Author(s):

Kyriakos A. Papavasiliou ◽

Dimitrios Stamiris ◽

Stavros Stamiris ◽

Antonia Bintoudi ◽

Eleftherios Tsiridis

Keyword(s):

Pathological Condition ◽

Hip Pain ◽

Diagnostic Challenge ◽

Mri Scan ◽

Wide Range ◽

Uncommon Condition ◽

The Right ◽

Increased Activity ◽

Ischiofemoral Impingement ◽

Quadratus Femoris

Introduction: Hip pain in children and adolescents may become a diagnostic challenge. A wide range of causes must be considered in the deferential diagnosis. Ischiofemoral impingement (IFI) is a pathological condition defined by hip pain associated with narrowing of the ischiofemoral (IF) space. We report the case of an adolescent patient with non-traumatic quadratus femoris (QF) tear secondary to an occult IFI syndrome. To the best of our knowledge, this is the first such case reported in the literature. Case Report: A 15-year-old girl reported persisting hip pain for a month following increased physical activity. The symptoms had started a couple of days following a weekend of increased activity due to her participating in a dancing contest. Physical examination and imaging studies (standard anterior pelvis radiograph and MRI-scan) failed to reveal any pathology apart from an area of diffused edema in the IF space. Standard hematology and biochemistry laboratory tests were all within normal range. Conservative treatment for 6 months with rest and modification of physical activities failed. A new MRI scan showed partial edema resolution and marked reduction in the IF and QF spaces (12 mm and 8 mm, respectively), thus suggesting IFI, which, in turn, led to a partial rupture of the QF. The patient underwent a local infiltration of the QF with betamethasone sodium phosphate and betamethasone acetate (6+6 mg/2 ml) under CT guidance, which led to the complete resolution of all her symptoms. She remains symptoms free for 24 months. Conclusion: IFI is a rather uncommon condition in the developing skeleton. As in adults, in adolescents as well, MRI is the study of choice in cases of IFI, since it shows QF pathology and allows measurement of the IF and QF spaces, assisting physicians in establishing the right diagnosis. However, the coexistence of a QF hematoma and/or edema, may temper with the initial MRI measurements and render the diagnosis of the primary condition rat

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Quadratus Femoris Muscle Injection for Chronic Left Hip/Buttock Pain

Anesthesiology ◽

10.1097/00000542-200209002-00930 ◽

2002 ◽

Vol 96 (Sup 2) ◽

pp. A930

Author(s):

Ahmed H. Ghaleb ◽

Marc Brower ◽

Gilbert Wong ◽

Marc Huntoon ◽

Scott Ross

Keyword(s):

Buttock Pain ◽

Femoris Muscle ◽

Quadratus Femoris

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ISCHIOFEMORAL IMPINGEMENT IN ADOLESCENTS: FROM CLINICAL PRESENTATION TO RETURN TO SPORTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00020 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0002

Author(s):

Javier Besomi ◽

Alan Garin ◽

Cristhian Herrera ◽

Pedro Salgado ◽

Selim Abara ◽

...

Keyword(s):

Clinical Presentation ◽

Hip Pain ◽

Return To Sports ◽

X Rays ◽

Imaging Findings ◽

Duration Of Symptoms ◽

Neck Shaft Angle ◽

Shaft Angle ◽

Ischiofemoral Impingement ◽

Quadratus Femoris

Background: Ischiofemoral impingement is an often unrecognized cause of hip pain in adolescents. It is caused by abnormal contact between the proximal femur and the ischium. The aim of our work is to describe clinical presentation, imaging findings and functional outcomes of ischiofemoral impingement in adolescents. Methods: We performed a retrospective study. Clinical files were reviewed (age, sex, type and duration of symptoms and hip physical examination). Imaging findings were evaluated in pelvis radiographs (presence of coxa profunda, acetabular protrusio, Wiberg angle, femoral neck shaft angle and acetabular retroversion) and in MRI (quadratus femoris edema, measurement of ischiofemoral and quadratus femoris space). Lower extremity functional scale (LEFS) were used to measured response to a physiotherapy protocol. Also relapse and time to sports return were recorded. Results: 24 hips, two bilateral in 20 female patients and 2 male patients, with 13 years-old on average (9-18) were obtained. Main symptom was hip pain with latency to consultant of 9 days on average (2-14). All patients practiced school sports, the most frequent was gymnastics. Positive FADIR test, ischiofemoral impingement test and pain on palpation of the ischium and gluteus medius were found in everyone. The median of Wiberg angle was 37º (25-48), femoral shaft angle 138º (128-144), and coxa profunda was present in 5 hips. MRI showed 13 hips with quadratus femoris edema, one with muscle atrophy, ischiofemoral space was 20 mm on average (16-25) and quadratus femoris space 17 mm on average (13-21). Our physiotherapy protocol was followed for all patients with a median of 18 sessions (10-30). LEFS improved from 56.4% (30-93) to 92% (80-100) (p=0,02). Time to turn asymptomatic was 6 months on average (3-13). With 2 years follow up, 2 hips had recurrence of symptoms. Time to sports return was 5 months on average (3-7). Conclusions: Ischiofemoral impingement is cause of hip pain in active female adolescents. X-rays are inespecific and MRI shows typically quadratus femoris edema. Conservative treatment with physiotherapy is an effective method that allows sports return in few months. This is the first report in the literature regards ischiofemoral impingement in pediatric population including results of treatment and return to sports.

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Contact-Related Strain of Quadratus Femoris, Obturator Externus, and Inferior Gemellus in an Australian Football Player: A Case Report

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0279 ◽

2019 ◽

Vol 28 (8) ◽

pp. 887-890

Author(s):

Michael Girdwood ◽

Liam West ◽

David Connell ◽

Peter Brukner

Keyword(s):

Case Report ◽

Return To Sport ◽

Football Player ◽

Return To Play ◽

Diagnostic Process ◽

Muscle Injuries ◽

Obturator Externus ◽

Muscle Groups ◽

Hip Flexion ◽

Quadratus Femoris

Context: Muscle injuries of the hip stabilizers are considered rare in sport. Objective: This report presents a previously unreported case of a contact injury resulting in acute strain of quadratus femoris, obturator externus, and inferior gemellus in an amateur Australian rules football player. Design: Level 4—case report. Case Presentation: A player was tackled ipsilateral to the injured leg, while in hip flexion in a lunged position. The case describes the diagnostic process, initial management, and return to play for this athlete. Results: Following rehabilitation, the player was able to return to sport at 8 weeks without ongoing issues. Conclusions: A literature search for sports-related contact injuries to either muscle returned only one result. All other documented cases of injury to these muscle groups are confined to noncontact mechanisms or delayed presentations. Despite conventional teaching, the action of the deep external rotators of the hip appears to be positionally dependent. Knowledge of this type of injury and mechanism may be useful for future clinical reasoning and differential diagnosis in patients with this type of presentation.

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