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儿童臀肌挛缩症的分类及不同治疗方法的疗效

Classification of gluteal muscle contracture in children and outcome of different treatments.

作者信息

Zhao Chen-Guang, He Xi-Jing, Lu Bin, Li Hao-Peng, Wang Dong, Zhu Zhen-Zhong

机构信息

Department of Orthopaedic Surgery, The 2nd Affiliated Hospital of Medical College, Xi'an JiaoTong University, Xi'an, Shaanxi, 710004, PR China.

出版信息

BMC Musculoskelet Disord. 2009 Apr 7;10:34. doi: 10.1186/1471-2474-10-34.

DOI:10.1186/1471-2474-10-34
PMID:19351391
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2671480/
Abstract

BACKGROUND

Gluteal muscle contracture (GMC) is a clinical syndrome due to multiple etiologies in which hip movements may be severely limited. The aim of this study was to propose a detailed classification of GMC and evaluate the statistical association between outcomes of different management and patient conditions.

METHODS

One hundred fifty-eight patients, who were treated between January 1995 and December 2004, were reviewed at a mean duration of follow-up of 4.8 years. Statistical analyses were performed using X2 and Fisher's exact tests.

RESULTS

Non-operative management (NOM), as a primary treatment, was effective in 19 of 49 patients (38.8%), while operative management was effective in all 129 patients, with an excellence rating of 83.7% (108/129). The outcome of NOM in level I patients was significantly higher than in level II and III patients (P < 0.05). The results of NOM and operative management in the child group were better than the adolescent group (P < 0.05). Complications in level III were more than in level II.

CONCLUSION

NOM was more effective in level I patients than in level II and III patients. Operative management was effective in patients at all levels, with no statistical differences between levels or types. We recommend NOM as primary treatment for level I patients and operative management for level II and III patients. Either NOM or operative management should be carried out as early as possible.

摘要

背景

臀肌挛缩症（GMC）是一种由多种病因引起的临床综合征，其中髋关节活动可能会受到严重限制。本研究的目的是提出GMC的详细分类，并评估不同治疗方法的结果与患者病情之间的统计学关联。

方法

回顾了1995年1月至2004年12月期间接受治疗的158例患者，平均随访时间为4.8年。使用X2检验和Fisher精确检验进行统计分析。

结果

作为主要治疗方法，非手术治疗（NOM）在49例患者中的19例（38.8%）有效，而手术治疗在所有129例患者中均有效，优良率为83.7%（108/129）。I级患者的非手术治疗结果明显高于II级和III级患者（P < 0.05）。儿童组的非手术治疗和手术治疗结果均优于青少年组（P < 0.05）。III级的并发症多于II级。

结论

非手术治疗对I级患者比II级和III级患者更有效。手术治疗对各级患者均有效，各等级或类型之间无统计学差异。我们建议将非手术治疗作为I级患者的主要治疗方法，将手术治疗作为II级和III级患者的治疗方法。非手术治疗或手术治疗均应尽早进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/a72076912650/1471-2474-10-34-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/5ddf2317a40a/1471-2474-10-34-1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/a72076912650/1471-2474-10-34-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/5ddf2317a40a/1471-2474-10-34-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/1a75411c33c6/1471-2474-10-34-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/97b8b8eca00c/1471-2474-10-34-3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a77/2671480/a72076912650/1471-2474-10-34-7.jpg

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MRI diagnosis of contracture of the gluteus maximus muscle.臀大肌挛缩症的磁共振成像诊断
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