daily anaswer
Scott Rand
A Trendelenburg gait would most likely be caused by which of the following lumbar conditions?
1. L3/4 far lateral disc herniation
2. L3/4 central disc herniation with impingement on the bilateral descending nerve roots
3. L4/5 far lateral disc herniation
4. L5/S1 far lateral disc herniation
5. L5/S1 paracentral disc herniation
A Trendelenburg gait is caused by gluteus medius weakness. Gluteus medius is
innervated by L5. Therefore a L5/S1 far lateral disc herniation could cause
this condition.
Gluteus medius originates from the dorsal ilium inferior to iliac crest and
inserts to the lateral and superior surfaces of greater trochanter. It is the
major abductor of thigh, and also functions to help to rotate the hip medially
and laterally. Arterial supply is by the superior gluteal artery. It is
mediated by the superior gluteal nerve, which is primarily innervated by L5. L5
also contributes to ankle dorsiflexion (combined with L4), great toe extension,
and sensation over lateral calf and dorsal foot.
Courtesy of Orthobullets
Scott E Rand, MD FAAFP CAQSM
Director, Primary Care Sports Medicine Fellowship
Co Director of Sports Medicine, Houston Methodist Orthopedics and Sports Medicine Willowbrook
Assistant Professor of Clinical Family Medicine Houston Methodist Academic Institute
Adjunct Assistant Professor of Family and Community Medicine, Texas A&M University
Assistant Professor of Family Medicine in Clinical Medicine Weill Cornell Medical College.
13802 Centerfield Dr Suite 300
Houston, TX 77070