iliopsoas retraction

The iliopsoas muscle retraction is used for the surgical treatment of hip deformities. 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: congenital hip abduction contracture and pelvic tilt Indication The iliopsoas muscle retraction procedure is applicable to: 1. Hip flexion internal rotation, knee flexion (hamstring tendon). 2. Hip flexion internal rotation, knee joint overextension (femoral quadriceps tendon). 3. The hip joint is flexed and the knee joint is normal. 4. Hip flexion deformity exceeds 15°. 5. When the hip is rotated while walking, the hip cannot be passively rotated when the joint is straight. The ideal age for surgery is 7 to 9 years old. Preoperative preparation Regular preoperative examination. Surgical procedure Bleck method: 1. Starting from the lower end of the anterior superior iliac spine 1.5cm, the anterior tibiofibular incision is made, obliquely inward and downward, about 10-15cm long. 2. Expose the sartorius muscle and retract it to the outside. Determine the inner and outer edges of the femoral nerve and diaphragm, and separate the nerve from the muscle. The diaphragmatic muscle fibers are overlapped with the large psoas muscle tendon, which is attached to the anterior medial aspect of the hip joint capsule. The diaphragm is cut transversely as far as possible at the distal end, and the psoas muscle tendon is cut at the attachment of its small rotor. 3. Displace the psoas muscle tendon upwards, sew it on the anterior capsule of the hip joint near the base of the femoral neck, and sew the diaphragm muscle fibers on the joint capsule. If there is a "scissors leg", both the adductor muscle tendonectomy and the obturator anterior branch resection can be performed at the same time.