Adductor Tenotomy and Obturator Anterior Branchectomy

Adductor tendonectomy and obturator anterior branch resection for surgical treatment of hip deformity. Lumbar muscle retraction, the tendon and diaphragm muscle fibers are implanted into the anterior joint capsule of the hip near the base of the femoral neck. Applicable to: 1 hip flexion internal rotation, knee flexion (hamstring tendon); 2 hip flexion internal rotation, knee joint overextension (femoral quadriceps tendon); 3 hip joint flexion internal rotation, knee joint normal; 4 hip flexion deformity exceeds 15°. If the sick child walks with scissors gait or hip abduction limited to 15 °, then long muscle resection and obturator anterior branch resection; if the patient walks with knee extension, straight The muscle origin is released; if the sick child walks in a knee-knee gait, the tendon of the semitendinosus should be transposed to the medial malleolus of the femur, and the semimembranosus muscle is prolonged. When the triceps of the calf have contracted, the Achilles tendon is prolonged. Hip dislocation can be treated with adductor tendonectomy and iliopsoas retraction. After 5 years of age, femoral varus rotation osteotomy can be performed. For acetabular dysplasia, Pemberton hip osteotomy can be performed in children older than 10 years of age. After 10 years of age, femoral shortening rotation osteotomy and Chiari acetabular reconstruction are performed simultaneously with soft tissue surgery. Treatment of diseases: dislocation of the knee Indication Adductor tendonectomy and obturator anterior branch resection are suitable for adductor muscle contracture, scissors gait or hip subluxation in early childhood. Preoperative preparation Regular preoperative examination. Surgical procedure 1. Make a 3cm longitudinal incision along the long rectus muscle or a 3cm transverse incision on the surface of the long rectus muscle. 2. Cut the subcutaneous tissue and deep fascia, separate the short-receiving muscle from the long-receiving muscle, and find the anterior branch of the obturator nerve, which runs between the long adductor and the short-receiving muscle. In order to protect the anterior branch of the obturator nerve, the long muscles are pulled apart and then the muscles are cut transversely, and electrocoagulation is used to stop bleeding to reduce the amount of bleeding. If the adduction contracture persists, the main reason for examining each muscle to determine the contracture of the contraction is the gracilis or short rectus muscle. Cut these muscles partially or completely with an electric knife until the adductor contracture is released. 3. The posterior branch of the obturator nerve is located on the surface of the adductor muscle, and the short rectus muscle is deep. If you need to do a short release of the muscles, identify and pay attention not to hurt the posterior branch of the obturator. After the withdrawal of the contraction, if the sick child is a simple sputum type, an obturator anterior resection can be performed when needed. 4. Layered closure of the wound.