Free Gracilis Transfer in the Treatment of Gluteus Medius Paralysis after Poliomyelitis

ABSTRACT

Paralysis of the gluteus medius after poliomyelitis often gives rise to secondary spinal deformity and inclination of the pelvis; the patient presents with a typical waddling gait. The paralysis is usually associated also with varying degrees of involvement and deformity of the extremities. Current treatment for paralysis of the gluteus medius has not been totally satisfactory. With the development of micro-neurovascular procedures, transfer of free muscle grafts for paralyzed or functionless muscles can be performed with functional recovery. The authors present a series of 12 cases, of which 10 were followed-up from 12 to 35 months. All of them had good cosmetic and functional results, with increased hip stability and stable gait. The operative technique, as well as the surgical anatomy, are described.