Evaluation of Trendelenburg and Duchenne signs by experimentally induced gluteal muscle paralysis.
Level 4 - case-series / case-control
Small prospective experimental interventional study in healthy volunteers without a control group
PubMed 42501605 · doi:10.1016/j.clinbiomech.2026.106931
What was done
Ten healthy adults underwent sequential nerve blocks targeting the tensor fasciae latae branch of the superior gluteal nerve, the gluteus medius and minimus branch of the superior gluteal nerve, and the inferior gluteal nerve supplying the gluteus maximus. After each block, participants attempted a ten-second single-leg stance. Pelvic drop and spinal obliquity were measured using a 56-marker, 27-camera 3D motion capture system to detect Trendelenburg or Duchenne signs.
What was found
Following tensor fasciae latae paralysis, 2 of 10 participants exhibited compensatory movement patterns. Following gluteus medius and minimus paralysis, 5 of 10 participants were unable to maintain a single-leg stance for ten seconds, and 1 of 10 exhibited a Trendelenburg sign. After gluteus maximus paralysis, 5 of 10 failed the single-leg stance, and 2 of 10 showed a Duchenne sign. Specific angles or quantitative kinematic degrees were not reported in the abstract.
Why it matters
This study demonstrates that the Trendelenburg and Duchenne signs are neither sensitive nor specific for isolated gluteus medius and minimus weakness, as gluteus maximus impairment can also induce these compensatory signs or cause stance failure.
Limits
The study is constrained by a very small sample size (n = 10) in healthy adults rather than clinical patients with chronic hip pathology. Because blocks were administered sequentially, the isolated effect of gluteus maximus paralysis without preceding abductor paralysis was not evaluated.