Abstract

The authors performed a retrospective study on 10 young patients (11 hips) presenting with a tight iliotibial band resistant to nonsurgical treatment. The main symptoms were pain and snapping of the hip during running and strenuous brisk walking. Diagnosis was made by the exclusion of other pathology and the elicitation of the snap. Surgical treatment was performed in all these patients to aid physiotherapy. The main principle of management however remains stretching exercises. When surgery is required, the aim is to elongate the iliotibial band. In our series, we used Z-plasty of the band followed by repair of the fascia as described by Stainsby. Our postoperative rehabilitation was different from Stainsby's, however. We allowed early progressive full weight bearing in contrast to the two weeks bed rest adopted by Stainsby. Stretching exercises were started two weeks after surgery; this was active in the first four weeks. The results were good at a mean follow-up period of 12 months (range: 8 to 24 months). Scar sensitivity was a problem in three of these patients; this responded only partially to a desensitization program. CONCLUSION: A reasonable result can be obtained following Z-plasty of a tight and symptomatic iliotibal band. Surgery is required only occasionally and there are associated complications, which must be discussed with the patients, these being recurrence of symptoms and wound problems.