Rai Saroj, Jin Shengyang, Meng Chunqing, Chaudhary Nabin, Tamang Nira, Wang Xiaohong, Liu Xianzhe, Wang Hong, Yang Shuhua
Department of Orthopedics, Wuhan Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jie Fang Avenue, Wuhan, 430022, China.
Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, China.
BMC Musculoskelet Disord. 2017 Mar 16;18(1):113. doi: 10.1186/s12891-017-1484-6.
Gluteal muscle contracture (GMC), a debilitating disease, usually starts in early childhood after variable dose of injections around the buttock, if left untreated it worsens gradually and persists throughout the life. Because the disease mostly affects adolescents and adults, there is always an aesthetic concerns. Purposeof the study was to introduce the arthroscopic F and C method of GMC release, and to compare its clinical efficiency with conventional open surgery in terms of clinical outcome, rate of complications, patient's satisfactions, and recurrence.
Between Jan 2013 and July 2015, 75 patients received an arthroscopic release with F and C release method and 71 patients received conventional open release of GMC. Primary surgeries in 16 years or older patients were included in the study. Two groups were compared clinically using Hip Outcome Scores - Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Scores - Sports Subscale (HOS-Sports), Visual Analogue Scale (VAS), and Ye et al. evaluation criteria.
No statistically significant differences were observed in Hip Outcome Scores - Activities of Daily Living Subscale (HOS-ADL) (P = 0.078), Hip Outcome Scores - Sports Subscale (HOS-Sports) (P = 0.340), and Visual Analogue Scale (VAS) (P = 0.524) between the two groups. 74 (98.7%) patients in the arthroscopic surgery group had good to excellent results, whereas 69 (97.1%) patients in the conventional open surgery group had good to excellent results (P = 0.727). No statistically significant difference was observed in recurrence rate (P = 0.612). Statistically significant differences were observed in incision length, use of post-operative analgesia, post-operative off-bed activity, and hospital stay. Complications were significantly higher in the conventional open surgery group (n = 21) than in the arthroscopic surgery group (n = 10) (P = 0.016). More importantly, cosmetic satisfaction was 100% in arthroscopic release group, whereas only 71% had cosmetic satisfaction in conventional open surgery group (P < 0.001).
Both, arthroscopic surgery and conventional open surgery, are highly effective tools for the GMC release in adolescent and adult patients. Arthroscopic GMC release with F and C method allows precise and selective release of contracture bands with small surgical trauma resulting fewer complications, high cosmetic satisfaction and minimal recurrence.
臀肌挛缩症（GMC）是一种使人衰弱的疾病，通常在儿童早期臀部周围接受不同剂量注射后发病，如果不治疗，病情会逐渐恶化并伴随终生。由于该疾病主要影响青少年和成年人，因此总是存在美观方面的问题。本研究的目的是介绍关节镜下F和C法松解GMC，并在临床疗效、并发症发生率、患者满意度和复发率方面将其与传统开放手术进行比较。
2013年1月至2015年7月，75例患者接受了关节镜下F和C松解术，71例患者接受了传统开放性GMC松解术。本研究纳入了16岁及以上患者的初次手术。使用髋关节功能评分-日常生活活动量表（HOS-ADL）、髋关节功能评分-运动量表（HOS-Sports）、视觉模拟量表（VAS）和Ye等人的评估标准对两组进行临床比较。
两组在髋关节功能评分-日常生活活动量表（HOS-ADL）（P = 0.078）、髋关节功能评分-运动量表（HOS-Sports）（P = 0.340）和视觉模拟量表（VAS）（P = 0.524）方面未观察到统计学上的显著差异。关节镜手术组74例（98.7%）患者效果良好至优秀，而传统开放手术组69例（97.1%）患者效果良好至优秀（P = 0.727）。复发率方面未观察到统计学上的显著差异（P = 0.612）。在切口长度、术后镇痛的使用、术后离床活动和住院时间方面观察到统计学上的显著差异。传统开放手术组的并发症（n = 21）明显高于关节镜手术组（n = 10）（P = 0.016）。更重要的是，关节镜松解组的美容满意度为100%，而传统开放手术组只有71%的患者对美容效果满意（P < 0.001）。
关节镜手术和传统开放手术都是青少年和成年患者GMC松解的高效工具。关节镜下F和C法松解GMC能精确、选择性地松解挛缩带，手术创伤小，并发症少，美容满意度高，复发率低。
