Abstract
INTRODUCTION: Snapping hip syndrome (SHS), particularly its external type, is a condition in which a tight iliotibial band (ITB) or gluteus maximus (G.Max) tendon mechanically "snaps" over the greater trochanter during dynamic hip movements. While often managed conservatively, persistent and painful cases may require surgical intervention. This report presents a case of refractory external SHS in a young female patient treated successfully using an open Z-plasty lengthening of the ITB. CASE REPORT: A 24-year-old physically active female presented with a 6-month history of audible snapping in the left hip, accompanied by pain for the preceding month. Examination revealed a positive Ober's test and reproducible snapping with hip flexion. Conservative measures failed. An open Z-plasty release of the ITB and partial G.Max release was performed, resulting in complete resolution of symptoms. CONCLUSION: Open Z-plasty is a safe and effective treatment for external SHS unresponsive to conservative management, offering direct visualization and reliable symptom relief.