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Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 97-100

The Surgical Treatment of Recalcitrant External Coxa Saltans by Ellipsoid-Shaped Segment Excision of the Iliotibial Band

Department of Orthopaedics, Patna Medical College, Patna, Bihar, India

Correspondence Address:
Dr. Rakesh Choudhary
H – 29, Doctors Colony, Kankarbagh, Patna - 800 020, Bihar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jodp.jodp_30_21

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Introduction: Snapping hip (coxa saltans) is an audible and sometimes painful disorder of the hip that occurs during activities that require repetitive flexion, extension, and abduction of the hip. Depending upon anatomic location of the offending structure, it may be external, internal, and intra-articular. The most common type is an external type in which structures external to the hip joint are primarily involved. This is usually the iliotibial band as it slides over the greater trochanter during repeated flexion and extension. Conservative therapy is the mainstay of treatment. For those cases who are refractory to conservative means, surgery can be considered. Materials and Methods: Only those patients undergoing operative intervention for symptoms refractory to conservative measures (>6 months) were included. Patients were excluded if they had concomitant diagnosis, prior fractures, childhood hip pathology, or prior surgical procedures. Ober test was performed to determine tightness of the iliotibial band. All patients underwent excision of an ellipsoid-shaped segment of iliotibial band over greater trochanter and removal of trochanteric bursae followed by Ober test. Results: Preoperative examination yielded an average hip flexion of 115.7°, extension of 7.14°, abduction of 43.6°, internal rotation of 16.4°, and external rotation of 34.3°. All seven hips demonstrated a palpable painful snap directly over the greater trochanter with flexion and extension with positive Ober test. Postoperative examination yielded an average flexion of 125.7°, extension of 13.6°, abduction of 52.1°, and internal and external rotation of 25° and 41.4°, respectively. The snap completely resolved and Ober tests were negative in all seven cases. Conclusion: We concluded that excision of an ellipsoid-shaped segment of iliotibial band over greater trochanter and removal of underlying trochanteric bursae as the primary surgical modality for relief in the refractory yet symptomatic snapping hip due to a tight iliotibial band.

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