Objective? To investigate the pathogenesis, diagnosis, and treatment of unilateral gluteal muscle contracture. Methods Between January 1990 and September 2009, 41 patients with unilateral gluteal muscle contracture were treated and the cl inical data were retrospectively analysed. Among them, 24 were male and 17 were female with an age range from 6 to 29 years (mean, 12 years). Thirty-nine patients had a definite history of repeat intragluteal injection. The locations were the left side in 9 cases and the right side in 32 cases. The main cl inical manifestations included lameness and abnormal gait. The medical examination showed pelvic obl ique and relative inequal ity of lower l imbs with a mean difference of 2.1 cm (range, 1.2-3.8 cm) in the distance form navel to malleolus medials. The X-ray films of pelvis showed outpouching trochanter of femur and pelvic obl ique. The CT scans showed no abnormal finding except pelvic obl ique and gluteal muscle contracture. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of the gluteal muscles was performed, followed by the skin traction of both legs and rehabil itation exercise. Results All incisions healed by first intention. Forty-one patients were followed up 1-20 years (mean, 5 years), and the signs of gluteal muscle contracture disappeared. After 1 year of operation, 34 patients had equal leg length, 5 patients had mild pelvic obl ique, and 2 patients had obvious pelvic obl ique. According to LIU Guohui et al. evaluation standard, the results were excellent in 33 cases, good in 6 cases, and poor in 2 cases with an excellent and good rate of 95.12% at 1 year after operation. Conclusion Unilateral gluteal muscle contracture leads to pelvic obl ique and inequal ity of lower l imbs, and it can be cured with the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter, combined with postoperative skin traction and rehabil itation exercises.
Objective To investigate the pathogenesis, diagnosis, and treatment of the gluteal muscle contracture associated with an unequal leg length caused by the pelvis obliquity (GMC-PO).Methods The retrospective analysis was made on the clinical features and the follow-up results in 132 patients who had been admitted from January 1990 to December 2004 for GMC-PO. Among them, 73 weremale and 59 were female with a range in age from 5 to 26 years (average, 11 yr). All the patients were characterized by unsymmetrical contracture of the gluteal muscles, including unilateral and bilateral contracture. Of the patients, 89 had a clear limping and 78 had a clearly-unequal leg length. The X-ray examination revealed pelvis obliquity in 97 cases and an increased angle of the femur neck in 11 cases. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of thegluteal muscles was performed, combined with the skin traction of both legs andexercise training. Results Of the 132 patients withunequal gluteal muscle contracture before operation, 13 had a relative length difference of 0.5-1.5 cm between the 2 legs, 1 had a difference of 3.0 cm,and the remaining 118 patients had an equal leg length. Excellent and good resultswere achieved in 118 and 13 patients, respectively after the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter,combined with postoperative skin traction and functional exercises. Only 1 patient had a poor result. The follow-up for 3 months to 14 years showed that thecure rate was as high as 99.2%.Conclusion The gluteal musclecontracture associated with an unequal leg length caused by the pelvis obliquity is a result of the unequal gluteal muscle contracture between the 2 hips and it can be cured with a comprehensive therapeutic method including the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateralarea nearby the greater trochanter, and postoperative skin traction as well as the functional exercise.
Objective To study some related factors of effect on gluteus muscle contraction and provide the therapeutic basis. Methods The curative effect was assessed in 154 patients who were classified by age, patient’s condition, orthopedic degree in operation and rehabilitation with an average follow-up period of 25 months(ranging from 5 to 36 months).Results The excellent rate of 18-24 years old (25/30) was lower than that of 5 -17 years old(120/124) (Plt;0.05); the excellent rate of slight patients was higher (107/109) than that of serious patients (38/45) (Plt;0.01); the excellent rate from higher orthopedic degree was higher(111/113) than that from lower orthopedic degree(34/41) (Plt;0.01); and the excellent rate of rehabilitation was much higher (107/110) than that of general treatment (38/44) （Plt;0.05）. Conclusion Age, patient’s condition, orthopedic degree in operation and rehabilitation are important factors to affect the curative effect on gluteu muscle contraction.
Objective To investigate the operative effects of gluteal muscle contracture. Methods A total of 128 cases of gluteal muscle contracture treated with operative methods from February 2001 to May 2009 were reviewed. Results All the patients received operation. Most patients were satisfied with the treatment via function exercise in the early stage. No severe complication was found. The patients were followed up for 6 to 84 months, at the average of 36 months. According to Huang Yaotians criteria, 67.9% (87/128) of the patients were excellent; 27.3% (35/128) were good; 3.9% (5/128) were fair; and 0.8% (1/128) were poor in effectiveness. Conclusion Operation and function exercise after operation have advantages of minitrauma and good function recovery, and it is a satisfactory method to treat the gluteal muscle contracture.
ObjectiveTo evaluate the safety of arthroscopic operation with artificial space on the buttocks for gluteal muscles contracture (GMC) by measuring the plasma osmolarity. MethodsBetween May and June 2011, 30 cases of GMC were joined in the study. Of them, 11 were male and 19 were female with an age range from 4 to 39 years (mean, 24.4 years). Twenty-eight patients had a definite history of repeat intragluteal injection. The disease duration ranged from 1-30 years (mean, 14 years). During operation, normal saline solution was used as lavage fluid, and radiofrequency energy was used as cutter for releasing GMC. The plasma sodium, plasma potassium, blood glucose, blood urea nitrogen concentrations, and plasma osmolarity were compared before and after operation; input and output volume of lavage fluid and intravenous dropping volume were recorded. Whether patients suffered from water intoxication or not was observed. The effect was evaluated through the criteria proposed by XIA Rongxi et al. ResultsThe operation was successfully completed in all patients, who had no water intoxication. The operation time was 16-70 minutes (mean, 33.4 minutes). The input volume was 2-23 L (mean, 6.3 L), the output volume was 2-22 L (mean, 5.8 L), and the absorption volume was 0.1-1.2 L (mean, 0.5 L); and the intravenous dropping volume was 350-1 300 mL (mean, 850 mL). No significant difference was found in plasma sodium, plasma potassium, blood glucose, blood urea nitrogen concentrations, and plasma osmolarity between before and after operations (P>0.05). All patients were followed up 3-26 months (mean, 12.7 months). At last follow-up, according to XIA Rongxi's et al evaluation standard, the results were excellent in 27 cases, good in 3 cases, and the excellent and good rate was 100%. ConclusionArthroscopic operation with artificial space on the buttocks is safe and reliable in the treatment of GMC.