IntroductionAs part of a series of dissections geared towards an improved anatomical understanding of Greater Trochanteric Pain Syndrome, it was observed that there were multiple tendons from the gluteus maximus inserting on the femur. In this study, the variability of the gluteus maximus tendon insertion was examined.MethodThe experiment was done on 40 partially dissected, embalmed bodies that were donated through the Willed Body Program at the University of North Texas Health Science Center. The gluteus maximus muscle belly was detached from the iliac crest. In addition, the iliotibial band was cut from the origin (ilium) and reflected to gain access to the gluteus maximus tendon. The fat in the area around the greater trochanter was cleaned until the tendon of the gluteus maximus was revealed.Results22 hips had only one tendon from the gluteus maximus inserting on the femur (13 on the right and 9 on the left), 19 hips had 2 tendons inserting (10 on the right and 9 on the left), 7 with 3 insertions (5 on the right and 2 on the left), and 1 with 4 insertions on the left side. When sex was separated, women had more insertions with 2 tendons than insertions with 1 tendon.ConclusionIt has been shown that there are multiple tendons from the gluteus maximus inserting into the femur.
PurposeGreater trochanteric pain syndrome (GTPS) is commonly diagnosed, and is thought to be at least in part caused by repetitive friction between the greater trochanter (GT) and iliotibial tract (ITT). We propose that the ITT has an important insertion into the proximal femur, the ITT‐ Femoral Insertion (ITT‐FI), which is the major contributor to this friction, rather the tibial extension of the ITT.MethodHips (n=20) were dissected on embalmed cadavers. The ITT‐FI was identified as the ligamentous structure remaining after excising the gluteus maximus (GM) and tensor fasciae latae (TFL) muscle fibers from the ITT, transection of the ITT at mid femur, leaving the ITT origin at the iliac crest and insertion on the femur (near the GM) intact. Measurements recorded include: length from the iliac crest to the femoral insertion of the ITT, the width of the ITT‐FI fibers, and the relative width of the pelvis as determined by the distance from anterior superior iliac spine (ASIS) to ASIS. Photographs were taken.ResultsThe proposed structure originates at the iliac crest and inserts inferior to the GT. The pressure between the ITT and the GT changed little if at all as palpated before and after isolating the ITT‐FI. Average measurements of the structure in length was 21.3cm, and width at the iliac crest was 4.6cm. Average width of the pelvis was 25.3cm.ConclusionThe femoral insertion of the ITT is identified, measured in dimension, and appears to be the chief cause of ITT static pressure on the GT. Future studies are needed to quantify this assertion.Grant Funding Source: none
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