微创小针刀松解治疗臀肌挛缩症的临床疗效评估  

Percutaneous release with a self-made needle knife under local anesthesia for gluteal muscle contracture

作　　者：梁佳林 黎牧帆 柏传毅[1] 刘瑞宇[1] 王坤正[1] 陈媛媛 党晓谦[1] LIANG Jia-lin;LI Mu-fan;BAI Chuan-yi;LIU Rui-yu;WANG Kun-zheng;CHEN Yuan-yuan;DANG Xiao-qian(The First Department of Orthopaedics,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院骨一科

出　　处：《中国矫形外科杂志》2019年第21期1965-1969,共5页Orthopedic Journal of China

摘　　要：[目的]评估微创小针刀松解治疗臀肌挛缩症的临床效果。[方法] 2009年10月~2017年3月共收治40例臀肌挛缩症患者,年龄15~18岁,双侧34例,单侧6例。所有患者采取侧卧位,常规消毒铺巾,行患髋关节内收状态下屈伸活动,当挛缩带滑过大转子时可用手触及紧张的挛缩带,在此部位进行局部麻醉。然后,术者在大转子上方1 cm处定位进针点,从后向前间断横行切割挛缩带,从而达到松解挛缩带的目的。调查患者术后外观满意度及功能满意度。比较患者手术前后关节活动度(ROM)、髋关节日常生活评分(HOS-ADL)、髋关节运动评分(HOSsport)及临床疗效评分的差异。[结果]每侧病变的平均手术时间为(15.54±2.53) min。术后有2侧髋出现局部血肿,未见伤口感染、臀肌无力、坐骨神经损伤等并发症。随访时间为31~62个月,患者的ROM、HOS-ADL评分、HOS-sport评分及临床疗效评分术前术后差异均具有统计学意义(P<0.05)。所有患者均达到外观满意(100%),38例患者(95.00%)达到功能满意。[结论]微创小针刀松解是一种安全、有效的治疗臀肌挛缩症的手术方式。[Objective] To evaluate the clinical outcomes of percutaneous release with self-made needle knife under local anesthesia for gluteal muscle contracture. [Methods] A total of 40 patients including 16 males and 24 females aged 15-18 years, involving bilateral hips in 34 patients and unilateral hip in 6 patients counted up 74 hips underwent percutaneous release of gluteal muscle contracture between October 2009 and March 2017. After the patients was placed on lateral position, and the contracture bands of gluteal muscles were felt under tension during passive hip flexion, extension and adduction, and percutaneously released from back to front at 1 cm above trochanter by a self-made needle knife under local anesthesia. The postoperative appearance, self-satisfaction, hip range of motions(ROM), HOS-ADL and HOS-sport scores were used for assessment of the clinical consequences. [Results] The operation time for one hip ranged from 10.12 to 20.18 min with a mean of(15.54±2.53)mins. Except local hematoma formation found in 2 patients, which did not lead serious consequences after proper management,no serious complications, such as sciatic nerve injuries, infection and gluteal weakness, happened in anyone of them. The follow-up period lasted for 31~62 months. The ROM of adduction and flexion, HOS-ADL and HOS-sports scores significantly improved at the latest follow up compared with those before operation(P<0.05). All patients(100%) satisfied to the cosmetic appearance, while 38 patients of them(95%) satisfied to their function. [Conclusion] This percutaneous release with self-made needle knife is a safe, effective and innovative method for treatment of gluteal muscle contracture.

关 键 词：臀肌挛缩症 髋 小针刀 微创手术 

分 类 号：R687[医药卫生—骨科学]