Abductor Paralysis and the Role of the External Oblique Transfer

Abstract

Hip abductor paralysis leads to gait abnormalities and to hip instability. Correction of abductor paralysis was first done by Mustard in patients with poliomyelitis and later adapted by Sharrard for patients with a myelomeningocele. The Mustard-Sharrard procedure is technically difficult, with strict indications for patient selection. By contrast, the external oblique transfer of Thompson has broad applicability and is a relatively simple operative procedure. This is a preliminary report of 37 external oblique transfers performed on poliomyelitic patients. The patient satisfaction rate is 89% and none of the patients who wore a pelvic band preoperatively required one postoperatively. While average followup is only nine months, this report supports the earlier work by Thompson. The procedure is successful in poliomyelitic patients and may also be appropriate for myelodysplastic patients.

Polio revisited: Reviving knowledge and skills to meet the challenge of resurgence

“…Occasionally, the transfer may only serve as a tenodesis without appreciable gain in motor power. Nevertheless, the Trendelenburg lurch may be minimized with iliopsoas and external oblique tendon transfers or a free gracilis transfer [11][12][13][14]. Paralysis of the gluteal maximus is also disabling with a characteristic lurch where the lumbar spine arches backwards during the stance phase of gait to compensate for the loss of hip Ignore shortening in the upper limb and if \2 cm in the lower limb extension power.…”