臀肌挛缩症临床分型与关节镜下微创手术

目的:探讨臀肌挛缩症的分型与关节镜下松解术的疗效。方法:臀肌挛缩症358例,男175例,女183例;平均年龄(19.7±6.8)岁(14～41岁),患者均有反复青霉素与苯甲醇溶媒肌肉注射史。按临床特点和术中挛缩束带情况分为:索条型(118例),扇型(107例),混合型(87例),阔筋膜张肌挛缩型(46例)。术后根据臀肌挛缩功能综合评价标准进行疗效评价。结果:术后随访321例,失访37例,随访时间平均3.5年(1.5～8.0年)。根据评价标准进行术后疗效评价,优303例,良13例,可5例。术后无复发、感染和神经血管损伤。结论:根据臀肌挛缩的分型选择手术方式有利于提高术后疗效。关节镜监视下等离子刀微创松解术治疗臀肌挛缩症,创伤小、操作安全、疗效可靠,有利于早期功能康复。

Clinical classification of gluteal muscle contracture under arthroscopy

Objective: To explore clinical effects of gluteal muscle contracture and minimum invasive surgery under the arthroscopy. Methods: Totally 358 patients with gluteus contracture were treated,which included 175 males and 183 females with an average age of (19.7±6.8) years old (ranged,14 to 41). All patients have a history of repetitive intramuscular injection of penicillin with benzyl alcohol solvent. According to clinical characteristics and intraoperative situation,patients were classified into four groups:cable strip (118 cases),fanshaped (107 cases),mixed (87 cases),tensor fasciae latae contracture(46 cases). The curative effects were evaluated according to postoperative function evaluation standard of gluteus contracture. Results: All patients were followed up and 37 cases withdrew. The following up time ranged from 1.5 to 8 years with an average of 3.5 years. According to evaluation standard of gluteus contracture,303 cases got excellent results,13 cases good,and 5 cases fair at the final follow-up. No recurrence,infection and neurovascular injury occurred. Conclusion: The classification of gluteal muscle contracture is beneficial for choose surgical strategy and improve curative effect. The advantage of plasma knife minimally invasive solution in treating gluteal muscle contracture with radiofrequency under arthroscopy is minimally invasive,safe,and benefit for early functional exercises.