【摘要】 [目的]探讨臀肌挛缩症的关节镜下分型与各型在关节镜下的手术疗效。[方法]臀肌挛缩症223例,男105例,女116例;平均年龄(19.7±6.8)岁(12~35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带情况分为:阔筋膜张肌挛缩型(105例),阔筋膜张肌合并臀大肌挛缩型(67例),混合型(51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223例,失访15例,随访时间平均3.5年(1.5~9.0年)。根据臀肌挛缩功能综合评价标准进行术后疗效评价,优198例,良18例,可7例。术后无复发、感染和神经血管损伤。[结论]根据Ober’s征、伸髋位内旋障碍、伸髋位内收障碍来判断阔筋膜张肌、臀大肌前部纤维、臀中肌挛缩情况,镜下分型有助于提高术中对肌肉挛缩的判断,改善术后疗效。更多还原

【Abstract】 [Objective] To explore the arthroscopic classifications and clinical effects of gluteal muscle contracture.[Methods] Totally 223 patients with gluteus contracture were treated,which included 105 males and 116 females with an average age of( 19. 7 + 6. 8) years old( range,12 ~ 35 years). All patients had a history of repetitive intramuscular injection of penicillin with benzyl alcohol solvent. According to clinical characteristics and intraoperative situations,patients were classified into three types: tensor fasciae latae contracture type( n = 105),tensor fasciae latae andgluteus maximus contraction type( n= 67),or mixed type( n = 51). The curative effects were evaluated according to postoperative function evaluation standard for gluteus contracture. [Results] Except 15 lost follow- up cases,all other patients were followed up for an average of 3. 5 years( range,1. 5 to 9 years). According to evaluation standard for gluteus constracture,198 cases were rated as excellent,18 cases as good and 7,as fair at the final follow- up. No recurrence,infection or neurovascular injury occurred. [Conclusion] According to Ober’s sign,internal rotation disorders with both hip and knee joint in 0°,abduction disorders with both hip and knee joint in 90°,we assessed the contraction of different muscles,which included tensor fasciae latae,gluteus maximus anterior fibers,gluteus medius. The arthroscopic classification of gluteal muscle contracture is benefical for choosing surgical strategy and improving curative effect.更多还原