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一名既往无转子周围髋部疼痛的患者出现臀中肌和臀小肌腱急性创伤性撕裂。

Acute traumatic tear of gluteus medius and minimus tendons in a patient without antecedant peritrochanteric hip pain.

作者信息

Stanton Michael C, Maloney Michael D, Dehaven Kenneth E, Giordano Brian D

机构信息

Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.

出版信息

Geriatr Orthop Surg Rehabil. 2012 Jun;3(2):84-8. doi: 10.1177/2151458512441795.

Abstract

Morphologic similarities between the abductor mechanisms of the hip and shoulder have given rise to the term rotator cuff tear of the hip. Although the true incidence of gluteus medius and minimus tears in the general population is unknown, the association between these tears and recalcitrant lateral hip pain has been described as greater trochanteric pain syndrome. Historically, tears of the gluteus medius and minimus have been thought to be attritional, and associated with chronic peritrochanteric pain, found incidentally during fracture fixation or hip arthroplasty, or with failure of abductor repair following arthroplasty utilizing the anterolateral approach. The literature supports favorable clinical outcomes with operative repair utilizing either endoscopic or open techniques. To our knowledge, there has never been a reported case of an acute traumatic tear of the gluteus medius and minimus that occurred without antecedant peritrochanteric hip pain. In this case, the patient was treated with acute open repair of the gluteus medius and minimus tendons within 3 weeks of injury and excellent clinical results were obtained at 6-month follow-up. Of note, the patient was notified and gave consent for his case to be used in publication.

摘要

髋关节和肩关节外展机制在形态学上的相似性,催生了“髋关节旋转袖套撕裂”这一术语。虽然一般人群中臀中肌和臀小肌撕裂的真实发生率尚不清楚,但这些撕裂与顽固性髋关节外侧疼痛之间的关联已被描述为大转子疼痛综合征。从历史上看,臀中肌和臀小肌的撕裂一直被认为是磨损性的,与慢性转子周围疼痛有关,在骨折固定或髋关节置换术中偶然发现,或与采用前外侧入路的关节置换术后外展肌修复失败有关。文献支持采用内镜或开放技术进行手术修复可取得良好的临床效果。据我们所知,从未有过无先前转子周围髋关节疼痛而发生的臀中肌和臀小肌急性创伤性撕裂的报道病例。在本病例中,患者在受伤后3周内接受了臀中肌和臀小肌腱的急性开放修复,6个月随访时获得了优异的临床结果。值得注意的是,已通知患者并获得其同意将其病例用于发表。

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本文引用的文献

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Abductor tendon tears of the hip: evaluation and management.髋关节外展肌腱撕裂:评估与处理。
J Am Acad Orthop Surg. 2011 Jul;19(7):385-91. doi: 10.5435/00124635-201107000-00001.
3
Endoscopic repair of gluteus medius tendon tears of the hip.髋关节臀中肌腱撕裂的内镜修复术
Am J Sports Med. 2009 Apr;37(4):743-7. doi: 10.1177/0363546508328412. Epub 2009 Feb 9.
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Rotator cuff tears of the hip.髋关节肩袖撕裂
Clin Orthop Relat Res. 1999 Nov(368):135-40.
8
Rotator-cuff tear of the hip.髋关节肩袖撕裂
J Bone Joint Surg Br. 1997 Jul;79(4):618-20. doi: 10.1302/0301-620x.79b4.7033.

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