双侧臀肌挛缩症的手术治疗

Surgical treatment for bilateral gluteal muscle contracture

目的:探讨经股骨大转子弧形向上后方延长至条索状块切口手术治疗臀肌挛缩症的疗效。方法:78例双侧臀肌挛缩症患者,男42例,女36例;年龄5～20岁,平均12.6岁。患者步态异常,双膝并拢不能下蹲,翘腿试验阳性,均存在Ober征阳性。双侧同时手术,采用经股骨大转子弧形向上后方延长至条索状块切口,术中探查臀肌挛缩情况,紧贴大转子上缘切断挛缩束带,切除部分挛缩组织,术后放置引流皮片。结果:78例患者随访6～36个月,平均24.4个月。依据夏榕圻疗效评定标准,优58例,良16例,差4例。无坐骨神经损伤及感染者。结论:采用经股骨大转子弧形向上后方延长至条索状块切口,手术创伤小,术后功能好,是治疗臀肌挛症缩满意的手术方案。

Objective：To investigate the operative effects of gluteal muscle contracture by the incision of along up-pone of the greater trochanter of femur comma reaching the trabs. Methods： Seventy-eight patients with bilateral gluteal muscle contracture, age from 5 to 20 years （mean 12. 6 years） were treated with operation. There were 42 male and 36 female. All patients had abnormal gait, inability to squat in the natural way, inability to cross their legs,and positive Ober＇s sign. Bilateral operation was procedured at the same time. Under the incision of along up-pone of the greater trochanter of femur comma reaching the trabs, contracture of gluteal muscle was explored,the contracture tissue bundle was cut at the site adjacent to the proximal border of the greater trochanter, part of the contractive tissue was reseeted and the rubber piece was inserted for drainage. Results：Seventy-eight patients were followed up from 6 to 36 months, average 24. 4 months. According to X/A Rong-qi＇s therapeutic evaluation standard, the results were excellent in 58 cases, good in 16 and poor in 4. Conclusion：The operative incision has the advantages of small trauma and good function recovery. It is a satisfactory method to treat the gluteal muscle contracture.