Goertzen M, Baltzer A, Voit T
Orthopädische Klinik und Poliklinik, Heinrich-Heine-Universität Düsseldorf.
Z Orthop Ihre Grenzgeb. 1995 Sep-Oct;133(5):401-4. doi: 10.1055/s-2008-1039945.
Although the cause of Duchenne muscular dystrophy has been recently found, there is no causal treatment to alter the natural course of this disease. Based on the recommendations by Glorion and Rideau with early treatment of contractures of the hips and the lower limbs we performed a modified release of the spina muscles, resection of tensor fasciae latae and a lengthening of the tendo calcaneus in 32 patients. The mean ae of DMD patients at time of operation was 6.1 yrs. The mean follow-up was 3.4 yrs. All children underwent mobilization the day after surgery. Complete correction of all contractures was immediately achieved after operation and kept in all but two cases up to the follow-up examination. No loss of ambulation was observed. Our results demonstrate that early selective surgery in DMD patients before or just at the onset of contractures without performing an additional aponeurectomy of the iliotibial band and percutaneous tenotomy of the hamstrings according to the original Glorion-Rideau-technique safely prevents severe contractures and should prolong ambulation.
尽管杜氏肌营养不良症的病因最近已被发现,但尚无改变该病自然病程的病因治疗方法。根据Glorion和Rideau关于早期治疗髋部和下肢挛缩的建议,我们对32例患者进行了改良的棘肌松解术、阔筋膜张肌切除术和跟腱延长术。手术时DMD患者的平均年龄为6.1岁。平均随访时间为3.4年。所有儿童在术后第二天开始活动。术后立即实现了所有挛缩的完全矫正,除两例外,直至随访检查时均保持矫正效果。未观察到行走能力丧失。我们的结果表明,在DMD患者挛缩出现之前或刚出现时进行早期选择性手术,不按照原始的Glorion-Rideau技术对髂胫束进行额外的腱膜切除术和对腘绳肌进行经皮肌腱切断术,可以安全地预防严重挛缩,并应延长行走时间。