Inferior Gluteal Nerve

Anatomy

  • Formed from L5, S1 and S2
  • Leaves the pelvis through the greater sciatic notch below piriformis
  • Enters the deep surface of gluteus maximus
  • Runs with the inferior gluteal vessels
  • Lies close to the sciatic and posterior femoral cutaneous nerves below piriformis
  • Supplies no skin
  • The posterior femoral cutaneous nerve can share a common trunk with it

Motor Supply

  • Gluteus maximus

Clinical Features

  • Weak hip extension
  • Difficulty climbing stairs and rising from a chair
  • Rarely injured in isolation
  • Gluteal wasting with flattening of the buttock
  • Injured with posterior hip dislocation and posterior acetabular fractures
  • Gluteus maximus gait with a backward lurch of the trunk at heel strike

Investigations

Posterior Approach to Hip, arteries of the gluteal and posterior femoral regions, gray’s anatomy plate 544
Arteries of the gluteal and posterior femoral regions, Gray’s Anatomy plate 544. Image by Henry Vandyke Carter, Wikimedia Commons, Public domain.
  • EMG of gluteus maximus
  • MRI of the pelvis for a mass at the greater sciatic notch
  • Nerve conduction studies of the sciatic nerve to exclude a combined lesion

Differential Diagnosis

  • S1 radiculopathy
  • Sciatic nerve injury, which also causes hamstring and foot weakness

Management

  • Prevention during posterior approaches
  • Physiotherapy with hip extensor strengthening
  • No reliable reconstruction exists for complete division

Structures at Risk

  • Extending the gluteus maximus split too far proximally in the posterior and Kocher-Langenbeck approaches, which denervates the upper part of the muscle
  • Gluteal injections placed too low and medial

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.