Gluteal drooping limp gait

Introduction When the ankle sprain or subluxation patient walks, the affected side often has a gait drooping gait. The ankle joint is composed of the auricles of the tibia and the tibia, and the joint surface is uneven, and the combination between the two is very close. The joint capsule of the ankle joint is tensioned. There are anterior tibiofibular ligament, posterior tibial ligament, iliac crest ligament and sacrospinous ligament between the anterior and posterior ankle joints. The ligament is strong and thus almost Can't move. The ankle joint is structurally a synovial joint with only minimal activity and plays an important role in pregnancy and childbirth.

Cause

Causes of gait sag gait:

(1) Causes of the disease: Most of them are related to acute sprains or labor in a bad position for a long time.

(B) the pathogenesis: the cause of ankle sprain or subluxation is mostly related to acute sprain or long-term work in a bad position. When the human body is erect, the gravity center line generates a certain torque through the front of the ankle joint; when the waist is bent, the spine is tilted forward, and the pelvis/rope muscle is pulled or fixed, which may cause sprain or strain of the ankle joint. In addition, during pregnancy, the ligaments may relax and gain weight due to the secretion of progesterone, causing the pelvis to tilt forward and downward, causing damage. In addition, the cause of iatrogenic injury is mainly caused by bone grafting for the posterior part of the iliac crest. If the range is too large, the ankle joint instability may be caused by the destruction of the iliac ligament.

an examination

Related inspection

Neurological examination EEG examination

Examination and diagnosis of gait in sulcus sulcus

Most patients are seen in severe physical activity, trauma or sedentary. A small number of patients may have no history of significant trauma.

In the acute attack period, pain may occur on the lower lumbar side, which is more serious and can be radiated to the buttocks or groin area; but generally it does not radiate to the calf nerve distribution area of the sciatic nerve. Patients often take the lateral or prone position, and the pain increases when turning over. Refused to stand, or take a flexion posture in the lower limbs. When walking, the affected side often has a gait sag.

At the time of physical examination, there may be localized tenderness at the ankle joint, limited straight leg elevation, and ankle pain. The pelvic separation test, the "4" Patrick test, the antagonistic hip abduction test, and the Yeomen test are all positive. Other activities that promote the rotation of the humerus can cause pain in the affected limb, but no nerve roots. Radiation pain.

There is no specific change in the early stage of X-ray examination, but inflammation of the ankle can occur in the later stage.

The diagnosis of this disease mainly depends on medical history, symptoms and signs, and X-ray examination can rule out other diseases. However, it should be noted that pain at the ankle joint may also exhibit similar symptoms due to lumbar disc herniation, inflammation, degeneration and hyperplasia of the lumbosacral joint itself. Therefore, the disease should be differentiated from diseases such as lumbosacral arthritis.

Differential diagnosis

The gait sag gait should be differentiated from the following symptoms:

1. Introduction to gluteal muscle atrophy: gluteal muscle atrophy is a clinical manifestation of progressive muscular dystrophy in myogenic diseases.

2. Introduction of gluteal muscle paralysis gait: gluteal muscle paralysis gait is a side gluteus medius lesion, polymyositis, progressive malnutrition and so on.

3. Introduction of gluteus medius injury: gluteal muscle injury is one of the common clinical lesions. The gluteus medius is located deep in the gluteus maximus, starting from the lateral side of the iliac crest and ending at the greater trochanter of the femur.

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