The Gluteal Region

Key points

• • The gluteal region is formed by three gluteal muscles: gluteus maximus (the largest, for standing up and climbing) over gluteus medius and minimus.
• • Gluteus medius and minimus abduct the hip and, crucially, steady the pelvis when standing on one leg during walking.
• • Weakness of gluteus medius or minimus, or of their nerve, makes the pelvis drop on the opposite side when standing on the affected leg, the Trendelenburg sign.
• • Many structures enter the region from the pelvis through the greater sciatic foramen, passing above or below the piriformis muscle.
• • The superior gluteal nerve supplies medius and minimus, while the inferior gluteal nerve supplies gluteus maximus.
• • Intramuscular injections in the buttock avoid the sciatic nerve, which crosses the lower part of the region; the ventrogluteal site is now generally preferred to the traditional upper outer quadrant.