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陈锟, 高鹏, 方潇翔, 等. 改良后的关节镜翻修松解术对开放术后有残留症状的臀肌挛缩症的临床疗效[J]. koko体育app 学报(医学版), 2024, 55(2): 297-302. DOI:
引用本文: 陈锟, 高鹏, 方潇翔, 等. 改良后的关节镜翻修松解术对开放术后有残留症状的臀肌挛缩症的临床疗效[J]. koko体育app 学报(医学版), 2024, 55(2): 297-302. DOI:
CHEN Kun, GAO Peng, FANG Xiaoxiang, et al. Clinical Efficacy of Modified Arthroscopic Revision Release of Gluteal Muscle Contracture With Residual Symptoms After Open Surgery[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(2): 297-302. DOI:
Citation: 🐻 CHEN Kun, GAO Peng, FANG Xiaoxiang, et al. Clinical Efficacy of Modified Arthroscopic Revision Release of Gluteal Muscle Contracture With Residual Symptoms After Open Surgery[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(2): 297-302. DOI:

改良后的关节镜翻修松解术对开放术后有残留症状的臀肌挛缩症的临床疗效

Clinical Efficacy of Modified Arthroscopic Revision Release of Gluteal Muscle Contracture With Residual Symptoms After Open Surgery

  • 摘要:
    目的 探讨对传统开放手术后效果不佳的臀肌挛缩患者进行改良后的关节镜翻修松解术的临床疗效。
    方法 回顾性收集2015年12月–2022年12月因传统开放手术后有臀肌挛缩残留症状而接受改良后的关节镜翻修松解术的患者。通过评估具体症状(包括患者双下肢假性不等长程度、髋关节内收内旋活动度、双膝能否并拢下蹲、仰卧时双腿能否交叉等)的改善情况以及术前和术后臀肌挛缩功能量表得分情况对手术疗效进行评估。采用配对t检验比较术前和术后测量值的差异是否有统计学意义。
    结果 36例患者取得了系统性随访,平均随访(22.4±4.9)个月。所有患者在末次随访时的臀肌挛缩功能量表评分均高于术前,从术前的(40.2±5.5)分升至(78.4±4.9)分(P<0.05)。在随访中,所有患者的髋关节内收内旋活动度都比术前有所改善,而且都能双膝并拢下蹲,但有1例患者在双腿交叉时仍有困难,27例(75%)术前存在双下肢假性不等长情况的患者在随访过程中都有不同程度的改善。在所有患者(72髋)中,有8髋出现皮下血肿和切口瘀斑,均在热敷等保守治疗后痊愈。有3髋出现髋外展肌力减弱,但经过术后锻炼和康复治疗,肌力逐渐恢复。没有患者出现皮下渗液、神经血管损伤或伤口感染等并发症。
    结论 改良后关节镜翻修松解术适用于传统开放手术后有残留症状的臀肌挛缩症病例。
     
    Abstract:
    Objective To investigate the clinical efficacy of modified arthroscopic revision release for patients who have gluteal muscle contracture and who have poor outcomes after traditional open surgery.
    Methods The data of patients who underwent modified arthroscopic revision release for residual symptoms of gluteal muscle contracture after traditional open surgery were retrospectively collected and analyzed. All subjects underwent the procedure between December 2015 and December 2022. The surgical efficacy was assessed by evaluating improvements in specific symptoms, including bilateral lower extremity inequality, hip internal rotation and adduction mobility, squatting with both knees pressed together, and the ability to cross one's legs in supine position, as well as the preoperative and postoperative results for the gluteal muscle contracture functionality scale. Paired t-test was performed to examine whether the differences between preoperative and postoperative measurements were statistically significant.
    Results A total of 36 patients were followed up systematically, with the mean follow-up period being (22.4±4.9) months. All patients had significantly higher scores for assessment with the gluteal muscle contracture functionality scale at the last follow-up than their preoperative assessment results, showing an increase from the preoperative scores of 40.2±5.5 to 78.4±4.9 (P<0.05). At the follow-up, all patients showed improvement in hip adduction and internal rotation mobility compared with their preoperative status and all patients were able to squat with both knees pressed together. Moreover, only 1 patient still had difficulty in crossing his legs. A total of 27 cases (75%) had preoperative leg length inequality, all of which improved to varying degrees at follow-up. Among all the patients (72 hips/cases), 8 cases had subcutaneous hematomas and incisional ecchymosis, which were resolved after conservative treatments such as hot compresses. 3 cases showed decreased hip abductor strength, but the muscle strength gradually recovered after postoperative exercise and rehabilitation. There were no complications such as subcutaneous exudate, neurovascular injury, or surgical site infection.
    Conclusion Modified arthroscopic revision release of gluteus muscle contracture is suitable for cases with poor outcomes after conventional open surgery.
     
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