Mi Yunfeng, Cheng Biao
Department of Orthopedics, Ningbo First Hospital, Affiliated Ningbo Hospital of Zhejiang University, No. 59 Liuting Street, Ningbo, Zhejiang Province, 315010, China.
Department of Orthopedics, School of Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, NO.301 Yanchang Middle Road, Shanghai, 200072, China.
BMC Musculoskelet Disord. 2020 Nov 14;21(1):748. doi: 10.1186/s12891-020-03766-5.
Gluteal muscle contracture (GMC) is a clinical syndrome characterized by the contracture of gluteal muscles, iliotibial band (ITB), and related fascia. GMC is much more prevalent in China, which has been proven to be associated with repeated intramuscular injections into the buttocks and the subsequent fibrosis and contracture.Generally, GMC is manifested mild. Here, we reported a severe case with arthrokatadysis.
A 25-year old man received multiple intramuscular injections of penicillin in the buttock when he was diagnosed with acute tonsillitis at 6 years old. Since then, he was injected penicillin regularly in local hospital because of the repeated acute tonsillitis until he was in high school. When the patient was found by the physical education teacher to be running in a state of external rotation of both feet, he was suggested to go to the hospital for treatment and was initially diagnosed to have GMC. He complained of occasional pain and limited range of motion in the hip joints. X-ray showed a typical arthrokatadysis. After arthroscopic release of GMC, the patient recovered well.
This is possibly the first reported case of arthrokatadysis that was caused by GMC after repeated intramuscular injections into the buttocks. Although the patient recovered well by arthroscopic surgical release of bilateral gluteus maximus contractures, GMC should be paid more attention and treated as early as possible.
臀肌挛缩症（GMC）是一种以臀肌、髂胫束（ITB）及相关筋膜挛缩为特征的临床综合征。GMC在中国更为常见，已被证明与反复臀部肌肉注射及随后的纤维化和挛缩有关。一般来说，GMC表现为轻度。在此，我们报告一例严重的关节强直病例。
一名25岁男性在6岁时被诊断为急性扁桃体炎时，在臀部接受了多次青霉素肌肉注射。此后，由于反复急性扁桃体炎，他在当地医院定期注射青霉素，直到上高中。当体育老师发现该患者跑步时双脚处于外旋状态时，建议他去医院治疗，最初被诊断为GMC。他抱怨髋关节偶尔疼痛且活动范围受限。X线显示典型的关节强直。经关节镜下松解GMC后，患者恢复良好。
这可能是首例因反复臀部肌肉注射导致GMC引起关节强直的报道病例。尽管通过关节镜手术松解双侧臀大肌挛缩后患者恢复良好，但GMC应得到更多关注并尽早治疗。
