摘要
目的探讨非手术的物理疗法以及手术治疗重度臀肌挛缩症的适应证和方法,提出该病的分级,分析分级的必要性和意义。方法根据制定的臀肌挛缩症的分级标准,将210名患者按病情轻重程度分为Ⅰ、Ⅱ、Ⅲ度。Ⅰ度采用非手术的物理疗法治疗;Ⅱ度及Ⅲ度患者全部采用经大转子内上方斜形小切口手术治疗。Ⅱ度患者手术彻底松解紧张纤维化的臀肌及挛缩增厚的阔筋膜;Ⅲ度患者手术松解必须深达髋关节囊,斜行切开关节囊后上方,行关节囊成形术。术后早期进行积极的并膝屈髋功能锻炼,防止粘连。结果Ⅰ度患者23例,经理疗、按摩治疗,所有症状均有不同程度减轻,有效率为100%,优良率为39%;Ⅱ、Ⅲ度患者187例,全部行手术治疗,优良率达97%。结论将臀肌挛缩症进行分级,更有利于准确的区别该病的轻重程度和选择相应的治疗方法。非手术疗法治疗臀肌挛缩症有一定的疗效,主要适用于Ⅰ度患者;手术治疗适用于Ⅱ、Ⅲ度患者,疗效满意。
Objective To explore the indications of physiotherapy and operative treatment for gluteal muscles contracture, and discuss the principles and necessity of classification in order to facilitate clinical management. Methods The standards of classification of gluteal muscles contracture were based on the signs and pathological examination, It consisted of three stages upon our standards. 210 patients could be divided into stage Ⅰof 23 cases, stage Ⅱand Ⅲ of 187 cases. For the patients of stageⅠ, physiotherapy was performed; However, all cases of stageⅡand Ⅲ, operative treatment was adopted by small superomedial incision above the greater trochanter. Furthermore, in the cases of stage Ⅱ, tight fibrotic gluteal muscles and thick contracted fascia lata should be released; For stage Ⅲ lesion, the release should be extended to the capsule of hip, and incision of the posterior capsule was necessary. Results In the group of stageⅠ, The symptoms and signs were relieved by maneuver , the rate of excellent and good results was 39%; while in the group of stageⅡand Ⅲ, it was 97% by operative treatment. Conclusion The staging system of gluteal muscles contracture could demonstrate exactly the severity degree of the disease, and is useful in choosing therapeutic method. Non-operatiive method can obtain satisfactory results in about 1/3 cases of stage Ⅰof gluteal muscles contracture; operative method is indicated for the patients of stage Ⅱand Ⅲ.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第2期96-99,共4页
Chinese Journal of Orthopaedics
关键词
骨科手术方法
臀肌挛缩症
分级
治疗
Contracture
Buttocks
Orthopedic procedures
Treatment outcome
