关节镜治疗臀肌挛缩症的疗效观察

Radiofrequency under Arthroscopy for Release of Gluteal Muscle Contracture

目的探讨关节镜治疗臀肌挛缩症的临床疗效。方法 2010年1月-2013年8月,94例（130髋）臀肌挛缩症（其中武警北京总队第三医院52例,武警总医院42例）,年龄18-25岁,平均21.5岁。参照贺西京等分级标准,Ⅰ级（轻度）11例（11髋）,Ⅱ级（中度）81例（116髋）,Ⅲ级（重度）2例（3髋）。均行关节镜下等离子钩刀松解。结果本组94例（130髋）,手术时间30-60 min,平均40.5 min,术中出血50-150 ml,平均70 ml。1例切口血肿,1例局部皮下积液,均治愈,无坐骨神经损伤、切口感染和裂开等。术后随访6-36个月,平均21个月。以步态、并膝下蹲、交腿试验、对运动的影响为评价标准,优78例,良16例。结论关节镜下手术治疗臀肌挛缩症,具有操作安全、疗效可靠、创伤小、并发症少、有利于早期功能锻炼和康复,疗效显著。

Objective To evaluate the clinical therapeutic effect of arthroscopic radiofrequency release of gluteal muscle contracture. Methods From January 2010 to August 2013,94 patients（ 130 hips） with gluteal muscle contracture,aged 18- 25 years old with an average of 21. 5,were treated by radiofrequency release under arthroscopy. Clinical classifications were done before operation in order to help to judge the range of the contractural tissues. There were 11 cases（ 11 hips） of grade Ⅰ,81 cases（ 116hips） of grade Ⅱ,and 2 cases（ 3 hips） of grade Ⅲ. The scars were released with a plasma cutter under arthroscopy. Results The operation time was 30- 60 minutes（ mean,40. 5 minutes） and the hemorrhage during operation was 50- 150 ml（ mean,70 ml）.Incision hematoma occurred in one patient and local subcutaneous hydrops in another,which were cured promptly. There were no complications such as injury of sciatic nerve,postoperative infection,or dehiscence after operations. All the 94 patients（ 130 hips）were followed up from 6 to 36 months with an average of 21 months. The surgical effect was evaluated according to patients＇ gait,squatting down while keeping their knees contacting,across leg test,and movement. Of the 94 patients,78 had excellent results,and16 were good. Conclusion Clinical therapeutic effect of the release of gluteal muscle contracture by arthroscopic radiofrequency is satisfactory and has less complications,helpful to early exercise and recovery.