注射性臀肌挛缩症48例小切口手术治疗体会

Small incision surgery for gluteus muscle contracture～a report of 48 cases

目的探讨臀肌挛缩症的发病原因及小切口手术疗效。方法对48例具有注射性臀肌挛缩症典型临床表现患者的病例特点进行分析,并对手术效果进行随访评价。结果本组病例的发病原因均与臀部肌肉注射有关,受累组织主要为臀中肌、阔筋膜张肌、臀小肌、臀大肌前缘筋膜及肌纤维。48例随访1.0～1.5年,平均1年2个月,手术优良率为97.9%,无坐骨神经损伤、伤口内血肿形成等并发症。结论手术治疗注射性臀肌挛缩症应强调早期、有效治疗,术中、术后应有效彻底止血,术后积极功能锻炼,具有创伤小,愈合快,关节功能恢复好等优点。

Objective To explore the pathogenesis of gluteus muscle contracture （GMC） and evaluate the effectiveness of the small incision surgery. Methods Forty-eight patients with typical clinical features of GMC were treated by small incision surgery. The pathogenesis of GMC was analyzed and the outcome of surgery was evaluated after a follow-up of 1.2 years （ranging from 1 to 1.5 years）. Results The pathogenesis of GMC might be attributive to intramuscular injection in buttocks. The affected tissues were mainly discovered in mesogluteus, muscles tensor fasciae late, muscles gluteus minimums, the anadesma and muscular fibers in the exterior edge of gluteus maximums. The excellent rate of surgical treatment was up to 97.9%. There was no these complications such as sciatic nerve injury and wound hecatomb found in follow- up. Conclusions The early invention would be the key for successful surgery. Complete and careful homeostasis should be carried out intra-operatively. Early exercise is crucial to the recovery of muscle function. The advantages of the procedure include less invasive, quick healing and good function recovery.