Obturator Externus: Difference between revisions
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
</div> | </div> | ||
== Description == | == Description == | ||
Obturator externus (OE) muscle is the conical shaped short external rotator located in the outer side of obturator membrane in lateral wall of pelvis. | Obturator externus (OE) muscle is the conical shaped short external rotator located in the outer side of obturator membrane in lateral wall of [[pelvis]]. | ||
<gallery> | <gallery> | ||
| Line 14: | Line 14: | ||
=== Origin === | === Origin === | ||
The Obturator externus (OE) muscle originates from the rami of pubis and ischium, the external bony margin of the obturator foramen in a clockwise direction from 12 o'clock around to the 10 o'clock position (right hip viewed from the front), and a few fibres arose from the obturator membrane.<ref name=":0">Gudena R, Alzahrani A, Railton P, Powell J, Ganz R. [https://journals.sagepub.com/doi/10.5301/hipint.5000249 The anatomy and function of the obturator externus.] Hip International. 2015 Sep;25(5):424-7.</ref><ref name=": | The Obturator externus (OE) muscle originates from the rami of pubis and ischium, the external bony margin of the obturator foramen in a clockwise direction from 12 o'clock around to the 10 o'clock position (right hip viewed from the front), and a few fibres arose from the obturator membrane.<ref name=":0">Gudena R, Alzahrani A, Railton P, Powell J, Ganz R. [https://journals.sagepub.com/doi/10.5301/hipint.5000249 The anatomy and function of the obturator externus.] Hip International. 2015 Sep;25(5):424-7.</ref><ref name=":2">Solomon LB, Lee YC, Callary SA, Beck M, Howie DW. [https://online.boneandjoint.org.uk/doi/epub/10.1302/0301-620X.92B9.23893 Anatomy of piriformis, obturator internus and obturator externus: implications for the posterior surgical approach to the hip.] The Journal of bone and joint surgery. British volume. 2010 Sep;92(9):1317-24.</ref> | ||
=== Insertion === | === Insertion === | ||
| Line 20: | Line 20: | ||
=== Nerve === | === Nerve === | ||
The posterior branch of the obturator nerve, L2-L4<ref name=":1" />. | The posterior branch of the [[Obturator Nerve|obturator nerve]], L2-L4<ref name=":1">Kendal, McCreary, Provance; Muscle Testing and Function with Posture and Pain; 4th Edition; Lateral Rotators of Hip Joint, Page 218.</ref>. | ||
=== Artery === | === Artery === | ||
| Line 27: | Line 27: | ||
== Function == | == Function == | ||
{{#ev:youtube|CglBvRB2JQ4}}<ref>Hip Rotator Series Part 1: Obturator Externus. Available from:https://www.youtube.com/watch?v=CglBvRB2JQ4 [last accessed 30/3/2020]</ref> | {{#ev:youtube|CglBvRB2JQ4}}<ref>Hip Rotator Series Part 1: Obturator Externus. Available from:https://www.youtube.com/watch?v=CglBvRB2JQ4 [last accessed 30/3/2020]</ref> | ||
* Obturator externus externally rotates hip during flexion but not in hip extension. | * Obturator externus externally rotates hip during neutral and flexion but not in hip extension.<ref name=":0" /> | ||
* It may assist in the adduction of the hip joint<ref name=":1" />. | * It may assist in the adduction of the hip joint during flexion <ref name=":1" />. | ||
* It helps to stabilise the head of the femur in the socket during flexion and internal rotation as it's posterior fibers reinforce the posterior capsule of hip joint. <ref name=":0" /> | * It helps to stabilise the head of the femur in the socket during flexion and internal rotation as it's posterior fibers reinforce the posterior capsule of hip joint. <ref name=":0" /> | ||
== Clinical relevance == | == Clinical relevance == | ||
* Obturator externus | * Solomon et al explored the role of the short external rotators in hip stability following a total hip replacement (THR) through a posterior approach. They noted that preservation of the piriformis and the external obturator reduces the risk of dislocation after THR indicating other approaches for THR.<ref name=":2" /> OE with its fibres which reinforce the posterior capsule acts as a [[Hip Anatomy|hip joint]] stabiliser.<ref name=":0" /> | ||
* | * Obturator externus(OE) bursa- OE bursa with bursal fluid was present between the transverse acetabular ligament and the OE muscle. Studies suggest that OE bursa is prevalent in hips with intra articular pathology than normal hips.<ref name=":0" /> | ||
* | * Repetitive eccentric contraction of Obturator externus causing musculotendinous tear in professional basketball players. Targeted rehabilitation will ensure a rapid return to competition without complication<ref>Coudert R, Coudreuse JM, Le Corroller T, Bensoussan L, Champsaur P, Delarque A, Viton JM. [https://www.sciencedirect.com/science/article/pii/S187706571500247X?via%3Dihub Obturator externus musculotendinous injury in a professional basketball player]. Annals of Physical and Rehabilitation Medicine. 2015 Sep 1;58:e67.</ref> | ||
* Impingement syndrome after total hip replacement-a close relationship between the musculo-tendinous part of the OE muscle and the inferior margin of the acetabulum can lead to the impringement syndrome if [[Hip Anatomy|transverse acetabular ligament]] is released or an acetabular cup position protruding beyond the caudal rim after arthroplasy. Releasing the OE insertion attachment to the posterior capsule decreased the risk of impingement. <ref name=":0" /><ref>Müller M, Dewey M, Springer I, Perka C, Tohtz S. [https://www.researchgate.net/publication/45388134_Relationship_between_cup_position_and_obturator_externus_muscle_in_total_hip_arthroplasty Relationship between cup position and obturator externus muscle in total hip arthroplasty.] Journal of orthopaedic surgery and research. 2010 Dec 1;5(1):44.</ref> | |||
== Assessment == | == Assessment == | ||
* [[Hip Examination]] | |||
* [[Goniometry: Hip External Rotation]] | |||
* [[Manual Muscle Testing: Hip External Rotation]] | |||
== Treatment == | == Treatment == | ||
* [[Therapy Exercises for the Hip]] | |||
== Resources == | == Resources == | ||
Revision as of 10:03, 30 March 2020
Original Editor - Manisha Shrestha
Top Contributors - Manisha Shrestha, Vidya Acharya and Kim Jackson
Description[edit | edit source]
Obturator externus (OE) muscle is the conical shaped short external rotator located in the outer side of obturator membrane in lateral wall of pelvis.
Anatomy[edit | edit source]
Origin[edit | edit source]
The Obturator externus (OE) muscle originates from the rami of pubis and ischium, the external bony margin of the obturator foramen in a clockwise direction from 12 o'clock around to the 10 o'clock position (right hip viewed from the front), and a few fibres arose from the obturator membrane.[2][3]
Insertion[edit | edit source]
It formed a musculotendinous junction at the level of the femoral neck. The fibres passed laterally along the inferior margin of the acetabulum, acting like a sling at the inferior part of the neck and inserted as a cylindrical tendon into the trochanteric fossa with some fibres extending towards the piriformis fossa.[2]
Nerve[edit | edit source]
The posterior branch of the obturator nerve, L2-L4[4].
Artery[edit | edit source]
The anterior branch of obturator artery and medial circumflex femoral artery.
Function[edit | edit source]
- Obturator externus externally rotates hip during neutral and flexion but not in hip extension.[2]
- It may assist in the adduction of the hip joint during flexion [4].
- It helps to stabilise the head of the femur in the socket during flexion and internal rotation as it's posterior fibers reinforce the posterior capsule of hip joint. [2]
Clinical relevance[edit | edit source]
- Solomon et al explored the role of the short external rotators in hip stability following a total hip replacement (THR) through a posterior approach. They noted that preservation of the piriformis and the external obturator reduces the risk of dislocation after THR indicating other approaches for THR.[3] OE with its fibres which reinforce the posterior capsule acts as a hip joint stabiliser.[2]
- Obturator externus(OE) bursa- OE bursa with bursal fluid was present between the transverse acetabular ligament and the OE muscle. Studies suggest that OE bursa is prevalent in hips with intra articular pathology than normal hips.[2]
- Repetitive eccentric contraction of Obturator externus causing musculotendinous tear in professional basketball players. Targeted rehabilitation will ensure a rapid return to competition without complication[6]
- Impingement syndrome after total hip replacement-a close relationship between the musculo-tendinous part of the OE muscle and the inferior margin of the acetabulum can lead to the impringement syndrome if transverse acetabular ligament is released or an acetabular cup position protruding beyond the caudal rim after arthroplasy. Releasing the OE insertion attachment to the posterior capsule decreased the risk of impingement. [2][7]
Assessment[edit | edit source]
Treatment[edit | edit source]
Resources[edit | edit source]
- ↑ Kenhub - Learn Human Anatomy. Functions of the obturator externus muscle - 3D Human Anatomy | Kenhub. Available from: https://www.youtube.com/watch?v=3LHk8KUAcw8 [last accessed 30/3/2020]
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Gudena R, Alzahrani A, Railton P, Powell J, Ganz R. The anatomy and function of the obturator externus. Hip International. 2015 Sep;25(5):424-7.
- ↑ 3.0 3.1 Solomon LB, Lee YC, Callary SA, Beck M, Howie DW. Anatomy of piriformis, obturator internus and obturator externus: implications for the posterior surgical approach to the hip. The Journal of bone and joint surgery. British volume. 2010 Sep;92(9):1317-24.
- ↑ 4.0 4.1 Kendal, McCreary, Provance; Muscle Testing and Function with Posture and Pain; 4th Edition; Lateral Rotators of Hip Joint, Page 218.
- ↑ Hip Rotator Series Part 1: Obturator Externus. Available from:https://www.youtube.com/watch?v=CglBvRB2JQ4 [last accessed 30/3/2020]
- ↑ Coudert R, Coudreuse JM, Le Corroller T, Bensoussan L, Champsaur P, Delarque A, Viton JM. Obturator externus musculotendinous injury in a professional basketball player. Annals of Physical and Rehabilitation Medicine. 2015 Sep 1;58:e67.
- ↑ Müller M, Dewey M, Springer I, Perka C, Tohtz S. Relationship between cup position and obturator externus muscle in total hip arthroplasty. Journal of orthopaedic surgery and research. 2010 Dec 1;5(1):44.
