Malinowski Konrad, Kalinowski Łukasz, Góralczyk Adrian, Ribas Manuel, Lund Bent, Hermanowicz Krzysztof
Artromedical Orthopaedic Clinic, Belchatow, Poland.
ORTIM Orthopaedic Clinic, Bialystok, Poland.
Arthrosc Tech. 2020 Oct 1;9(10):e1553-e1557. doi: 10.1016/j.eats.2020.06.017. eCollection 2020 Oct.
Classically, external snapping hip syndrome (ESHS) is considered to be caused by friction of a tight iliotibial band (ITB) over the greater trochanter (GT), which leads to pain, inflammation, and palpable or audible snapping. Surgical treatment remains a gold standard in patients resistant to conservative measures. Many surgical procedures addressing ESHS exist in the literature, but the vast majority of them involve only plasties of the ITB. However, observations led us to the conclusion that friction of the ITB over the GT may not be the only cause of ESHS and other structures like gluteal fascias or an anterior scarred part of gluteus maximus may be involved. The aim of this article is to provide a detailed description and video demonstration of an endoscopic surgical procedure using a "fan-like" cut to treat the ESHS. Its greatest advantage is the ability to gradually increase the extent of surgery based on intraoperative observations. It turns the procedure into a tailor-made surgery, which offers good and reproducible results.
传统上，外侧弹响髋综合征（ESHS）被认为是由紧张的髂胫束（ITB）在大转子（GT）上摩擦所致，这会导致疼痛、炎症以及可触及或可听到的弹响。对于保守治疗无效的患者，手术治疗仍是金标准。文献中有许多针对ESHS的手术方法，但其中绝大多数仅涉及ITB的整形。然而，观察结果使我们得出结论，ITB在GT上的摩擦可能不是ESHS的唯一原因，其他结构如臀筋膜或臀大肌前部瘢痕化部分可能也参与其中。本文旨在详细描述并通过视频演示一种使用“扇形”切口的内镜手术方法来治疗ESHS。其最大优点是能够根据术中观察逐步扩大手术范围。这将该手术转变为一种量身定制的手术，可提供良好且可重复的效果。
