儿童臀肌挛缩症并骨盆倾斜的手术治疗

Surgical treatment for gluteal muscle contractures with obliquity of pelvis

目的探讨儿童臀肌挛缩症并骨盆倾斜的手术治疗方法及疗效。方法臀部挛缩组织切断松解或延长术(29例)、臀肌起点下移术(11例)治疗儿童臀肌挛缩症并骨盆倾斜。结果40例术后平均随访5年,采用臀部挛缩组织松解或延长术29例中,臀肌挛缩体征及骨盆倾斜完全消失24例,部分改善3例,2例无明显改善。臀肌起点下移术11例中,臀肌挛缩及骨盆倾斜症状完全消失9例,部分改善2例。结论经臀肌大转子顶端的小切口进行臀部挛缩组织切断松解或者延长手术,对治疗轻症臀肌挛缩症并骨盆倾斜简便、有效;而臀肌起点下移术是治疗儿童重症臀肌挛缩并骨盆倾斜的有效方法。

Objective To evaluate the surgical treatment methods and effects of gluteal muscle contracture （GMC） with obliquity of pelvis. Methods 29 cases of GMC with obliquity of pelvis were treated with release or lengthening of the contracture of gluteal muscles, 11 with distal transfer of origins of gluteal muscles. Results All patients were followed up for 5 years on average. 24 of 29 children who had release or lengthening of the contracture of gluteal muscles procedures got normal movement range of hip joints and correction of obliquity of pelvis, 3 got partly improvement and 3 got no change. 9 of 11 patients who had distal transfer of origins of gluteal muscles got normal movement range of hip joints and correction of obliquity of pelvis and 2 got partly improvement. Conclusions It is simple and effective to treat mild contracture of gluteal muscles with obliquity of pelvis with release or lengthening of the contracture of gluteal muscles through small incision above greater trochanter of femur. Distal transfer of origins of gluteal muscles is effective for the contracture of gluteal muscles with severe obliquity of pelvis.