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时间:2020-05-18
《臀大肌止点肌腱Z字延长术治疗重度臀肌挛缩症.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·524·中国骨伤2015年6月第28卷第6期ChinaJ0~hopTrauma,Jun.2015,Vo1.28,No.6经验交流·臀大肌止点肌腱Z字延长术治疗重度臀肌挛缩症陈焕诗,杨小龙(柳州市柳铁中心医院骨三科,广西柳州545007)【摘要】目的:探讨臀肌挛缩筋膜松解联合臀大肌止点肌腱z字延长术治疗重度臀肌挛缩症的临床疗效。方法:选择2006年5月至2011年5月20例35侧重度臀肌挛缩症患者,其中男12例,女8例;年龄8~34岁,平均l3岁;病程3-21年。患者均表现有不同程度的步态异常,双膝并拢不能下蹲,Ober
2、征阳性,翘腿试验阳性,术中进行臀肌挛缩筋膜松解后,再将臀大肌止点肌腱作z字延长治疗。随访对比观察治疗前后步态、并膝屈髋下蹲试验、交腿试验、髋关节内收及内旋活动度、髋关节外展后伸肌力(臀大肌力量)及运动能力等。结果:20例均获随访,时间1—5年。臀大肌松解均彻底,弹响均完全消失,Ober征均阴性,髋关节并膝屈髋、髋内收、髋内旋角度与术前比较差异有统计学意义(P<0.01),臀肌肌力得到保护,髋关节活动度及运动能力等恢复良好,其中优31侧,良4侧。结论:对于重度的臀肌挛缩患者,在进行传统的臀肌挛缩筋膜松解后再将臀大肌止点肌腱
3、作Z字延长,无须过多切除正常的臀肌纤维及破坏关节囊,即可使臀肌挛缩得到最大程度的松解,术后疗效确切。【关键词】臀;外科手术;挛缩DoI:10.3969/j.issn.1003—0034.2015.06.010Insertionofgluteusmaximustendo—chilieslengtheningthZ—shapedforthetreatmentofsevereglutealmusclecon-tractureCHENHuan—shiandYANGXiao—long.TheThirdDepartmentofOrt
4、hopaedics,LiuzhouMunicipalLiutieCentralHospital,Liuzhou545007,Gnangxi,ChinaABSTRACT0bjective:Toinvestigateclinicalcurativeefectsofglutealmusclecontracturereleasecombinedwithinsertionofgluteusmaximustendo—chilleslengtheningwithZ—shapedintreatingsevereglutealmuscle
5、seontraeture.Methods:From2006Mayto2011May,20patients(35sides)withsevereglutealmuscleeontraeturewerecollected,including12malesand8females,agedfrom8to34yearsoldwithanaverageof13yearsold;thecoursesofdiseaserangedfrom3to21years.Allpa—tientsmanifestedabnormalgaitatdif
6、erentdegree,kneesclosetogethercannotsquat,positivesyndromeofOber,positivetestofaliceleg.Gluteuseontraeturefasciareleasewereperformedfirstlyinoperation,theninsertionoftendo—chilieslengtheningwithZ—shapedwerecarriedout.Preoperativeandpostoperativegait,andkneeflexio
7、nhipextensorsquattest,CROSSlegtest,ad—ductionandinternalrotaryactivityofhipjoint,stretchstrengthandmotorabilityafterhipabductionwereobservedandcom—pared.Results:Twentypatientswerefollowedupfor1to5years.Gluteusmaximuswerereleasedthoroughly,andsnappinghipwasdisappe
8、ared,Obersyndromewerenegative.Therewassignificantdiferencesinkneeflexionhipextensorsquattest,ad—ductionandinternalrotaryactivityofhipjoint,stretchbeforeandafte
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