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臀肌挛缩症的病因 类型及治疗 |
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黄耀添 李建文 雷伟 王臻 赵黎 朱庆生 李华林
【摘要】目的 根据臀肌挛缩症的病因分类，说明臀肌挛缩症是由多种原因引起的一组以髋关节功能障碍为主要表现的临床症候群。方法 对101例具有臀肌挛缩症典型临床表现患者的病因、病理特点进行分析，并对手术效果进行随访评价。结果 注射性臀肌挛缩症71例占70.3％。特发性臀肌挛缩症20例，先天性髋脱位术后并发臀肌挛缩症3例，臀筋膜间室综合征引起的臀肌挛缩症2例，感染性臀肌挛缩症1例，多发性肌筋膜挛缩症表现的臀肌挛缩症4例，其中臀部肌注是最主要的致病原因。73例随访0.5～8年，平均4.8年，手术优良率为95.9％。结论 任何原因造成的臀肌及其筋膜挛缩、纤维化均可引起臀肌挛缩症的临床表现，根据病因结合病变程度分类有助于更好地认识并指导治疗臀肌挛缩症。
【关键词】挛缩 手术疗法 髋关节
Gluteal Muscle Contracture — Etiology, Classification and Treatment
HUANG Yaotian*, LI Jianwen, LEI Wei, et al.
*Institute of Orthopedics of PLA, Xijing Hospital,Fourth Military Medical University, Xi’an 710032
【Abstract】 Objective To demonstrate that gluteal muscle contracture(GMC) is a clinical syndrome of hip presenting the functional disorder resulted from a variety of causes, with reference to the aetiology and classificaton of GMC. Methods 101 patients presenting the typical symptom and sign of GMC with a particular reference to the aetiology and pathology were reviewed to evaluate the outcome of surgical treatment. Results The GMC were caused by injections in 71,idiopathic in 20, post-operative in 3, gluteal compartment syndrome in 2, gluteal infection in 1, and systemic multiple muscle and fascial contracture in 4. Intragluteal injection was the predominant cause of GMC in this series. Seventy-three patients was followed for an average of 4.8 years (range, 0.5 to 8 years). 95.9％ of the patients treated surgically had good and excellent results. Conclusions Gluteal muscle and fascial contracture or fibrosis due to a variety of causes may lead to the GMC. The understanding of the etiology and classification is helpful and instructive in the diagnosis and treatment of GMC.
【Key words】 Contracture Surgery methods Hip joint
臀肌挛缩症（gluteal muscle contracture，GMC）是由多种原因引起的臀肌及其筋膜纤维变性、挛缩，引起髋关节功能受限所表现的特有步态、体征的临床症候群。自1970年Valderrama[1]报告以来国内外已有众多报道，但病因及分类尚不十分明确。本文报告我所1982年9月～1997年6月收治的101例各种类型的G[1] [2] 下一页
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