858例臀肌挛缩症不同术式治疗的回顾性分析

Retrospective analysis of Gluteus contracture in 858 cases and the treatment on severe cases

对1983～1988年2月80例，1988年3月～1997年2月778例臀肌挛缩症前、后两期分别行不同术式治疗，通过对比治疗回顾性分析，认为臀肌挛缩症病变的范围不仅限于臀大肌及其筋膜，重症患者还有臀中小肌、梨状肌、髋关节囊、韧带等广泛病变。重症臀肌挛绪症除松解髂胫束外，还应分离广泛的粘连。除松解臀中肌外，挛缩的臀小肌、梨状肌、关节囊、韧带都应松解。术中应直视下显露坐骨神经并予以保护，以免损伤。术中可用不同方法止血，术后可不用引流。术后形成的增生疤痕可在半年后逐渐减轻，不必为此行手术切除或术后进行预防性放射治疗。

Through retrospective comparison- tharapentic analysis of gluteus contracturein 858 cases from 1983 to 1997, demonstrated that the range of affection was extensive.Not only gluteus maximus and its fascia but also gluteus medius, gluteus minimus, piriformis, hip capsule and ligaments were involved in severe cases. Besides iliotibial bandall the extended adhesion and contracted muscles must be released in severe cases. Thesciatic nerve should be exposed under directvision and protected against injury. Varioushemostatic methoods may be used, and drainage is not necessary during the operation.Postoperative scar will be atrophied within half a year and needn' t do operation or prophylactic radiotherapy.