臀肌肌力不平衡所致骨盆倾斜的生物力学与治疗

目的 了解臀肌肌力不平衡所致骨盆倾斜患儿术后恢复情况，探讨骨盆倾斜原因及各种方法的治疗机制。方法 对78例因臀肌肌力不平衡而致骨盆倾斜患儿进行长期随访，测量肢体长度的改变及骨盆倾斜恢复情况。68例臀肌挛缩症患儿采用选择性挛缩臀肌松解术，10例臀部硬纤维瘤患儿采用扩大切除术，术后辅以功能锻炼、皮牵引及单足跳治疗。结果 经6～18个月随访，78例患儿中，76例骨盆完全恢复正常，2例患儿虽经功能锻炼和皮牵引治疗但未能恢复。结论 臀肌肌力不平衡所致骨盆倾斜是一种可逆性病变，手术去除导致臀肌肌力增高的原因是治疗的关键。术后臀肌功能锻炼及皮牵引有助于骨盆倾斜的恢复。单足跳是促进此型骨盆倾斜恢复的一种简单而有效的方法。

Treatment and Biomechanics of the Pelvis Oblique Caused by Strength Imbalance of Gluteal Muscles

Objective To know the rehabilitate degree of the pelvis obligue caused by the strength imbalance of the gluteal muscles and explore the pathogeny of pelvis oblique and therapeutic mechanisms of different therapy. Methods 78 children with pelvis oblique caused by the strength imbalance of the gluteal muscles were followed up ,the changes of the limb length and pelvis position recovery degree were detected of all 78 cases ,68 were the gluteal muscles contracture,who were treated with selective excision of the contractured gluteal musclar fibers. The bumps in buttocks in 10 cases with desmoid were extensively excised. The gluteal muscle functional exercises, the bilateral skin traction and a single leg skipping training were performed in the postoperation. Results After 6~18 months followed up, 76 cases of them, the oblique pelvis was recovered to natural position completely. Two cases did not recovery, though the gluteal muscles exercises and skin traction were also carried out. Conclusions The pelvis oblique caused by the strength imbalance of the gluteal muscles is reversible pathological change, we consider that by the operative excision to clear the cause of abnormal high strength of gluteal muscles is a therapeutic key, gluteal muscles exercises and skin traction in the postoperation in timely are beneficial, and the skip training also is a simple, effective auxiliary method to correct the pelvis oblique.