臀肌挛缩微创松解对骨盆矢状面倾斜改变的三维步态分析  

Three-dimensional gait analysis of minimally invasive release of gluteus contracture on altered sagittal plane tilt of pelvis

作　　者：卢林 吴云龙 陈海诚 周驰[1] 陈镇秋[1] LU Lin;WU Yunlong;CHEN Haicheng;ZHOU Chi;CHEN Zhenqiu(Department of Necrosis of the Femoral Head,The First Afiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院股骨头坏死科,广东广州510405 [2]中山火炬开发区人民医院骨二科,广东中山528437

出　　处：《中国骨与关节损伤杂志》2024年第6期561-565,共5页Chinese Journal of Bone and Joint Injury

基　　金：广州地区临床高新、重大和特色技术(2023-2025年)建设项目(2023P-TS22)。

摘　　要：目的基于三维步态分析观察臀肌挛缩症患者微创松解术后骨盆矢状面倾斜变化及相关力学因素。方法纳入自2021-05-2021-11于广州中医药大学第一附属医院股骨头坏死科行微创松解术治疗的10例双侧臀肌挛缩症患者(观察组),并选取10例性别、年龄、身高、体重等基本信息与观察组相匹配的健康人作为对照组。采用意大利BTS三维步态分析系统(SMART-DX400)对观察组术前、术后3个月的静态及日常速度行走的骨盆矢状面活动参数进行测量,对照组进行一次三维步态分析作为观察组标准参数。结果观察组术后3个月骨盆矢状面运动角度及髋关节屈伸角度的最大值、最小值及静态角度均大于术前,差异有统计学意义(P<0.05),但骨盆矢状面运动角度的幅度、步幅占身高比与术前差异无统计学意义(P>0.05)。观察组术前、术后3个月骨盆矢状面运动的幅度及静态角度均大于对照组,差异有统计学意义(P<0.05),但术前、术后3个月两组骨盆矢状面运动角度的最大值与最小值差异无统计学意义(P>0.05)。观察组术前髋关节伸展角度最小值、幅度均小于对照组,差异均有统计学意义(P<0.05),但两组髋关节屈曲角度最大值差异无统计学意义(P>0.05)。观察组术后3个月髋关节屈曲角度最大值、最小值及静态角度与对照组比较差异无统计学意义(P>0.05)。观察组术前步幅占身高比小于对照组,差异有统计学意义(P<0.05),但术后3个月步幅占身高比与对照组差异无统计学意义(P>0.05)。结论微创松解术能改善臀肌挛缩症患者髋关节屈伸角度、运动幅度,但是对术后挛缩解除下骨盆前倾的增加、臀肌主动肌力不足以及长期代偿姿势下累积性损害的影响较小,腰部肌群对于平衡姿势的影响术后仍存在,术后进行骨盆前倾调整及臀肌肌力训练、腰部肌群的整体功能训练,有利于术后功能恢复、步态改善。Objective To observe changes in pelvic sagittal tilt and related mechanical factors after minimally invasive release surgery in patients with gluteal myoclonus based on three-dimensional gait analysis.Methods Ten patients with bilateral gluteal myoclonus treated with minimally invasive release surgery at the Department of Triple Orthopaedics of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from May 2021 to November 2021(the observation group)were included,and 10 healthy individuals with basic information such as gender,age,height,and weight matched with the observation group were selected as the control group.Pelvic sagittal plane activity parameters of static and daily speed walking in the observation group were measured using the Italian BTS three-dimensional gait analysis system(SMART-DX400)preoperatively and 3 months postoperatively,and the control group was subjected to one three-dimensional gait analysis as a standard parameter for the observation group.Results In the observation group,the pelvic sagittal plane movement angle as well as the maximum value,minimum value and static angle of hip flexion and extension angle 3 months after operation were greater than those before operation,and the differences were statistically significant(P<0.05),but the differences in the amplitude of the pel-vic sagital plane movement angle and the ratio of the stride length to the height compared to those before operation were not statistically significant(P>0.05).The amplitude and static angle of pelvic sagittal plane movement before and 3 months after operation in the observation group were greater than those in the control group,and the difference was statistically significant(P<0.05),but the differences in the maximum and minimum values of the pelvic sagittal plane movement angle before and 3 months after operation were not statistically significant between the two groups(P>0.05).The minimum value and amplitude of hip extension angle before the operation in the observation group wer

关 键 词：臀肌挛缩 三维步态分析 骨盆矢状面倾斜 

分 类 号：R685[医药卫生—骨科学]