Different pathological situation involving muscle and or nerve produced severe limb and discomfort. We present our experience of two different procedures to treat these conditions: modified Sharrard or muscular plasty: gluteus maximus stitched to facia lata. Modified Sharrard in adult; which consist in transferring the terminal portion of psoas iliacus on the lesser trochanter through the iliac bone and attach it on the greater trochanter. Material and method 11 modified Sharrard were performed over a 40 years period. Four after complex acetabular fracture previously orifed. Three in conjunction with a THR. One after traumatic hip dislocation. One conversion of a fused hip with a THR. One in conjunction with a total hip revision. One after tumor excision. One after excision of Teuschlander disease. Two after palsies (polio and spina bifida). Seven procedures were performed in males, 4 in females. Age from 20 to 59. Six transferts were associated to a THR. Results No specific complications. Evaluation: pain, range of motion, limp, patient satisfaction. Two were lost to follow-up. One complete failure (Polio). Eight had a long term follow-up from 2 to 18 years. Results: very good 5, improved but fair in 2, failure in one associated with total hip revision. The indication is limited to patients having a severe palsy of the abductor and gluteus maximus following hip dislocation, fracture of the acetabulum or other conditions like Teutschlander syndrom or spina bifida. Muscular plasty Against pure gluteus medius palsy, we recommend a muscular plasty stitching the gluteus maximus to the facia lata after detachment of the iliac crest insertions. Three patients: from 21 to 59. All after gluteus Medius excision for sarcoma. Two in conjunction with massive prosthesis reconstruction. Three excellent results with a follow-up from 4 to 15 years. Conclusion Hip palsy is a severe condition that can be addressed by some selected surgery.
L. Sedel (Thu,) studied this question.