Gluteal Fibrosis. A report of 28 cases from Kumi Hospital, Uganda

Abstract

Background: Gluteal fibrosis is a muscle disorder marked by intramuscular fibrous bands within the substance of the gluteal muscle. These bands lead to secondary contractures that affect the function of the hip joint(s). Different hypotheses have been put forward concerning the etiology of gluteal fibrosis. A congenital muscular dysplasia was postulated by Hnevkovsky¹⁰ and a lesion similar to the sternocleidomastoid muscle contracture in congenital tortocollis was suggested by Fairbank and Barret Llyoyd-Roberts and Thomas called attention because of severe systemic disease in infancy or childhood.

Patients and Methods: Twenty eight cases of gluteal fibrosis seen from August 2004 to May 2006 are presented. All cases had bilateral gluteal fbrosis and the severity of the condition depicted the clinical picture. All of them but two had been treated with IM Quinine. The two exceptions had been one with IM Penicillin and the second with Streptomycin. One case had both gluteal fibrosis and paralytic drop foot. The treatment in all of them was incision of the fibrous tissue followed by squatting and sitting exercises. One of the cases was complicated by foot drop following sciatic nerve injury but recovered after 6/12

Results: Our results were excellent and brought smiles to faces of many patients and parents. Three months after Surgery hip flexion averaged between 80 and 130 degrees. Two of our cases were complicated by sepsis and one developed paralytic foot drop