New Minimally Invasive Option for the Treatment of Gluteal Muscle Contracture
New Minimally Invasive Option for the Treatment of Gluteal Muscle Contracture
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治疗臀肌挛缩的微创新选择
DOI：
10.3928/01477447-20121120-11
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发表时间：
2012-12-01
期刊：
影响因子：
1.1
通讯作者：
Xu, Shuogui
中科院分区：
文献类型：
--
作者：
Ye, Bin;Zhou, Panyu;Xu, Shuogui
臀肌挛缩症是一种临床综合征，涉及挛缩和扭曲的臀肌和筋膜纤维由于多种原因。体格检查显示髋关节内收和大腿内侧旋转的特征性步态。本研究介绍了一种新的微创手术方法来解除臀肌挛缩症。将臀肌挛缩症分为4类：A型，主要发生在髂胫束，B型，发生在髂胫束和臀大肌，C1型，可触及收缩带移动，下蹲时可听到咔嗒声，C型，可触及收缩带，C型，可触及收缩带。而C2型，收缩带运动不可触及或几乎不存在，蹲下时可听到啪的一声。这种分类方法可以预测这些病理性挛缩的解剖位置，并确定所需的手术类型。四个关键点被用来定义手术领域，并作为点，以标记小于4毫米的手术切口。挛缩很容易释放在这个仔细标记的手术领域，而不会造成显着的神经血管损伤。在2003年3月至2008年6月的5年期间，作者用这种方法治疗了1059例患者，并取得了良好的结局。大多数患者在术后早期康复计划的帮助下，在12周内完全活跃。最严重的并发症是术后关节周围血肿，3例患者在术后10天内发生，需要手术结扎出血血管。
Gluteal muscle contracture is a clinical syndrome that involves contracture and distortion of the gluteal muscles and fascia fibers due to multiple causes. Physical examination demonstrates a characteristic gait due to hip adduction and internal thigh rotation. This study introduces a new minimally invasive method for surgical release of gluteal muscle contracture. Patients with gluteal muscle contracture were assigned to 4 categories: type A, contracture occurred mainly in the iliotibial tract; type B, contracture occurred in the Iliotibial tract and gluteus maximus; type C1, movement of the contraction band was palpable and a snapping sound was audible during squatting; and type C2, movement of the contraction band was not palpable or almost absent and a snapping sound was audible during squatting. This classification method allowed prediction of the anatomic location of these pathological contractures and determination of the type of surgery required. Four critical points were used to define the operative field and served as points to mark a surgical incision smaller than 4 mm. The contracture was easily released in this carefully marked operative field without causing significant neurovascular damage. Over a period of 5 years, between March 2003 and June 2008, the authors treated 1059 patients with this method and achieved excellent outcomes. Most patients were fully active within 12 weeks, with the assistance of an early postoperative rehabilitation program. The most significant complication was a postoperative periarticular hematoma, which occurred in 3 patients within 10 days postoperatively and required surgical ligation of the bleeding vessel.