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Superior Gluteal Nerve

nervus gluteus superior

The superior gluteal nerve supplies the primary hip abductors and the TFL, exiting the pelvis above the piriformis unlike the sciatic and inferior gluteal nerves that exit below it. Injury during posterior hip approaches or from deep gluteal injection produces a Trendelenburg gait from gluteus medius and minimus paralysis. The nerve is the primary motor supply for the muscles that prevent pelvic drop during single-leg stance.

Region: Pelvis & Hip

Anatomical Data

Origin, Insertion & Supply

Origin	Sacral plexus (L4, L5, S1)

Clinical Relevance

Clinical Notes

Superior gluteal nerve injury during posterior total hip replacement produces a persistent Trendelenburg lurch that significantly impairs gait mechanics and patient satisfaction. Safe posterior hip approaches stay at least 5 cm proximal to the greater trochanter tip to avoid the nerve's terminal branches. Superior gluteal nerve palsy from injection injury or pelvic pathology produces the Trendelenburg gait without gluteus maximus weakness, distinguishing it from inferior gluteal nerve lesions.

Pathology

Common Injuries & Conditions

Superior Gluteal Nerve Palsy

Hip abductor paralysis from posterior surgical approach or injection injury producing Trendelenburg gait, managed with gait rehabilitation and abductor strengthening where residual function remains.