Gluteus maximus release and fibrous contracture bundle amputation

The gluteus maximus release and the fiber contraction are used for the treatment of gluteal muscle contracture in children. Children's gluteal muscle contracture is generally considered to be due to repeated gluteus maximal intramuscular injection of antibiotics and other drugs caused by muscle fibrosis. It is also thought to be related to the predisposition or genetic factors of some children. Muscle fibrotic contracture not only causes abduction and external contracture deformity of the hip joint, but also may cause changes in the pelvic structure of the child. Therefore, X-ray examination of some children may be characterized by obturator deformation. The formation mechanism is: 1 The fibrosis of the buttock muscles and their fascia loses its normal stretchability, resulting in a fibrous contracture band, which limits the adduction and internal rotation of the hip joint and does not bend the hip in the neutral position. When the contraction reaches the gluteus medius and the posterior aspect of the hip capsule, the symptoms are more obvious; 2 the gluteal muscles and bones are not well developed, because the childhood bones are not yet mature, the fibrotic muscle tissue and the bones at the starting and ending points Growth and development cannot grow in direct proportion. That is to say, the development of the pelvis and femur is fast, and the slow development of the gluteal muscle makes it relatively shorten and contracture, which limits the internal rotation of the hip joint and may affect the development of the pelvis. This explains not only the child. Most of the symptoms appeared gradually 2 to 3 years after intramuscular injection, and also explained the cause of obturator deformation in some children with X-ray examination. The treatment emphasizes that the diagnosis should be timely, the surgery should be performed, the muscles should be loosened and cut off, and the effects on hip function and pelvic structure should be relieved, which is beneficial to the development of the child and the recovery of limb function. Curing disease: Indication The gluteus maximus release and fibrotic contraction are suitable for the diagnosis of gluteal muscle contracture and are not effective after non-surgical treatment. Surgical procedure 1. Incision Start the incision from the gluteus maximus near the humerus, until the big trochanter, and extend it vertically downwards. 2, revealing the collapsed belt Separate the gluteus maximus to expose the fiber contracture band and cut it. In order to prevent the reattachment of the two ends, it is advisable to remove the fiber band 1~2cm, and remove the scar tissue formed around. 3, cut off the bundle The iliac crest is exposed from the large trochanter of the femur, and the gluteus maximal fiber and the iliac crest are cut transversely to achieve the purpose of completely releasing the gluteus maximus; Z-extension can also be used according to the degree of contracture. 4, suture incision Wash the wound with isotonic saline, completely stop bleeding, leave the rubber drainage strip, and suture the incision according to the level.