Trendelenburg Gait
A characteristic abnormal gait pattern caused by weakness or paralysis of the hip abductor muscles (primarily gluteus medius and gluteus minimus).
Mechanism
- In normal gait, the hip abductors on the stance leg contract to stabilize the pelvis and prevent the contralateral side from dropping.
- In the Trendelenburg gait, the weak abductors on the stance side fail to stabilize the pelvis.
- Result: The pelvis drops (tilts downward) on the swing (contralateral) side.
Clinical Manifestations
| Feature | Description |
|---|---|
| Trendelenburg Sign | Pelvic drop on the side opposite to the weak muscle when standing on one leg. |
| Compensatory Gait | The patient leans the torso toward the affected (weak) side to shift the center of gravity over the stance leg. |
High-Yield Exam Pearl:
The most common cause of Trendelenburg gait is a lesion of the superior gluteal nerve. However, it can also be seen in conditions involving the hip joint itself, such as developmental dysplasia of the hip (DDH) or severe hip osteoarthritis, where pain or structural issues limit abductor function.