臀肌挛缩伴骨盆倾斜症的发病机制及治疗

目的：分析伴骨盆倾斜的臀肌挛缩症的发病机制，。以此指导临床治疗，方法（1）1990年1月－2000年1月共收治臀肌挛缩症病人143例，其中伴骨盆倾斜患者31例，全部行手术治疗。术中重点探查臀大肌，臀中肌的挛缩情况并视具体情况行松解或肌腱延长术。（2）观察，分析臀部肌内解剖以探讨臀肌挛缩症病人发生骨盆倾斜的机制，结果：（1）经随访，手术后除1例遗留轻微踊行，1例遗留约6度骨盆倾斜外，余病人均步态正常，骨盆倾斜消失，达到临床治愈。（2）结合解剖学观察及术中所见，认为单纯臀大肌挛缩不会导致骨盆倾斜，臀中肌挛缩才会导致骨盆倾斜。结论：臀中肌挛缩是伴骨盆倾斜的臀肌挛缩症病人的发病机制，对此类病人只要早发现，治疗方法正确，均能取得良好的效果。

Study of Mechanism and Treatment of Gluteal Muscle Contracture with Obliquity of Pelvis

Objective: To analyse the mechanism of gluteal muscle contrature(GMC) with obliquity of pelvis, then using it guiding the treatment. Method: 1. From Jan. 1990 to Jan. 2000, we applied surgical treatment to 31 cases of GMC with obliquity of plevis. In operation we emphasized in the situation of contracture of gluteal muscles, then cut the contracture tract or extended the tendon. 2.To study the mechnism of GMC with obliquity of pelvis by analysing the anatomy of gluteal muscles. Result: All patients were normal but one lamed lightly and another one still had 6 degrees obliquity of pelvis postoperatively. By anatomic research and the situation of contracture tracts, we found that the contracture of middle gluteal muscle was the reason of obliquity of pelvis but maximus muscle would not cause it. Conclusion: Contracture of middle gluteal muscle was the mechanism of GMC with obliquity of pelvis. Patients should be operated immediately and could get fine results.