We present a previously unreported case of acute obturator internus and Obturator externus strain in an adolescent.
MRI revealed high grade right obturator internus and obturator externus muscle strain involving the attachments to the obturator ring and ischium (Figure 2).
It passes through the following structures in the following order: gracilis, adductor brevis muscle, obturator externus
muscle, obturator membrane, and beneath or through the obturator internus muscle and periurethral endopelvic connective tissue; it finally exits through the opened vagina.
Once placed, the ends of the mesh penetrate the obturator membrane and obturator externus
but not the adductor compartment of the thigh and groin.
Quadratus femoris (QF), piriformis, obturator internus, obturator externus, and superior and inferior gemelli are the deep external rotator muscles of the hip joint (Fig).
One participant had an absent QF on the left side on both MRI and USI, and the MRI demonstrated that the obturator externus had aberrant anatomy and had filled the QF space.
After preparation of the space between the anteroinferior capsule and the psoas tendon, the ischium is approached proximal to the obturator externus
The fascia from the obturator externus and adductor magnus muscles was removed without damaging the branches of the obturator nerve.
The obturator internus and obturator externus muscles are connected with the obturator membrane.
The gluteals (maximus, medius, and minimus) and the "deep six" muscles of the hip (piriformis, quadratus femoris, obturator internus, obturator externus
, gemellus superior, and gemellus inferior) serve to flex, extend, abduct, adduct, and medially or laterally rotate the hip.
The anchor goes not only into the obturator internus, but into the membrane and the obturator externus
Among the muscles traversed, the adductor brevis is the first, followed by obturator externus
and then internus.