Yang Yingguo, Peng Zixuan, Shi Linlin, Wang Ye, Wang Yuan, Ge Bing, Zhu Dongcheng, Ye Zhiyuan
Department of Orthopedics, Sihong Hospital, Sihong, Jiangsu Province, China.
Kangda College of Nanjing Medical University, Lianyungang, Jiangsu Province, China.
BMC Musculoskelet Disord. 2024 Dec 19;25(1):1024. doi: 10.1186/s12891-024-08150-1.
To explore the method and curative effect of minimally invasive treatment of gluteal muscle contracture (GMC) with self-made special cutter combined with special compression hemostasis device.
The data of 88 patients with GMC treated in our hospital from May 2017 to January 2021 were analyzed retrospectively. They were divided into two groups according to different surgical instruments and hemostatic devices. The minimally invasive group consisted of 44 cases, including 18 males and 26 females aged between 7 and 25 years, with a disease duration ranging from 3 to 21 years. Among them, there were 27 cases of grade I and 17 cases of grade II who underwent treatment using a self-made special cutter for GMC combined with a self-made special compression hemostasis device. The traditional group also had 44 cases, including 17 males and 27 females aged between 6 and 23 years, with a disease duration ranging from 4 to 20 years. In this group, there were 25 cases of grade I and 19 cases of grade II who underwent open gluteal contracture fasciolysis combined with traditional abdominal band compression to stop bleeding. The incision length, operation time, intraoperative bleeding, and postoperative bleeding were compared between the two groups.
There were no complications such as infection, hip instability and sciatic nerve injury in the two groups. The cross-leg test, knee squat, gait and movement returned to normal. Both Ober's sign and frog leg sign were negative. One patient in the traditional group developed a secondary hematoma after the incision, which was cured by incision and drainage again. The incision length (1.3 ± 0.2 cm) in the minimally invasive group was significantly shorter than that in the traditional group (6.4 ± 1.4 cm), and so was the operation time (46.3 ± 7.9 min vs. 62.2 ± 15.1 min). Meanwhile, the amount of intraoperative bleeding (33.7 ± 11.5 ml vs. 60.9 ± 25.0 ml) and postoperative bleeding (51.1 ± 19.4 vs. 112.9 ± 36.2 ml) in the minimally invasive group was significantly lower than that in the traditional group, respectively (P < 0.05).
The minimally invasive treatment of grade I and grade II GMC with a self-made special cutter combined with a special compression hemostatic device can achieve favorable clinical outcomes. Additionally, it causes less trauma, simplifies the operation, reduces intraoperative and postoperative bleeding, allows for early functional exercise, and promotes rapid functional recovery. Therefore, this treatment deserves clinical application.
探讨自制专用刀具联合专用压迫止血装置微创治疗臀肌挛缩症(GMC)的方法及疗效。
回顾性分析2017年5月至2021年1月在我院治疗的88例GMC患者的资料。根据手术器械和止血装置的不同将其分为两组。微创组44例,其中男18例,女26例,年龄7~25岁,病程3~21年。其中Ⅰ级27例,Ⅱ级17例,采用自制GMC专用刀具联合自制专用压迫止血装置进行治疗。传统组也为44例,其中男17例,女27例,年龄6~23岁,病程4~20年。该组中Ⅰ级25例,Ⅱ级19例,采用开放性臀肌挛缩松解术联合传统腹带压迫止血。比较两组的切口长度、手术时间、术中出血量及术后出血量。
两组均未出现感染、髋关节不稳及坐骨神经损伤等并发症。交腿试验、屈膝下蹲、步态及活动均恢复正常。奥伯征(Ober's sign)和蛙腿征均为阴性。传统组1例患者术后切口出现继发性血肿,经再次切开引流治愈。微创组切口长度(1.3±0.2cm)明显短于传统组(6.4±1.4cm),手术时间(46.3±7.9分钟对62.2±15.1分钟)也明显缩短。同时,微创组术中出血量(33.7±11.5ml对60.9±25.0ml)和术后出血量(51.1±19.4对112.9±36.2ml)均明显低于传统组(P<0.05)。
采用自制专用刀具联合专用压迫止血装置微创治疗Ⅰ、Ⅱ级GMC可取得良好的临床效果。此外,其创伤小,操作简便,减少了术中及术后出血,可早期进行功能锻炼,促进功能快速恢复。因此,该治疗方法值得临床应用。