髋部解剖体表投影分区对臀肌挛缩镜下松解术的临床价值

发布时间：2018-03-17 01:05

  本文选题：臀肌　切入点：挛缩带　出处：《中国矫形外科杂志》2017年03期 　论文类型：期刊论文

【摘要】：[目的]探讨髋部解剖体表投影分区对镜下臀肌挛缩松解术的临床价值。[方法]2014年12月~2015年7月间,对96例臀肌挛缩症患者参考髋部解剖体表投影分区行关节镜下挛缩带松解手术,男41例,女55例,平均年龄(24.9±4.4)岁(18~36岁)。患者均有反复臀部肌肉注射药物史,术前查体均有下蹲及翘腿困难,髋部弹响,Ober’s征阳性。髋部解剖体表投影分区:依据髋部解剖学特征,将其划分为9个区,分区界线呈"井"字形网格,将界线及重要解剖结构在体表投影标记以供手术参考。术后对患者下蹲活动、髋部弹响、Ober’s征、神经血管有无损伤、伤口有无血肿、髋关节外展肌力及对生活工作影响情况进行综合评估。[结果]术中松解在第8区96例(100%),第5区68例(71%),第2区52例(54%),第4区31例(32%)。术后随访1年以上,患者均无下蹲及翘腿困难,Ober’s征、髋部弹响均为阴性,无神经血管损伤,无术后伤口血肿,1例髋关节外展肌力弱(肌力Ⅳ级)。臀肌挛缩功能评分术前为49.2(26~70)分,术后末次随访为91.2(81~100)分,两者差异有统计学意义(P0.05)。[结论]手术安全区划分有助于判定局部解剖结构,避免神经血管肌肉等重要解剖结构的损伤风险,有助于描述记录病变情况和教学。
[Abstract]:[objective] to investigate the clinical value of hip anatomical surface projection for gluteal muscle contracture release under microscope. [methods] from December 2014 to July 2015, 96 cases of gluteal muscle contracture were treated with arthroscopic decompression of contracture zone under arthroscopy with reference to the subdivision of anatomic surface projection of hip. There were 41 males and 55 females with an average age of 24.9 卤4.4 years and 1836 years old. All patients had a history of repeated intramuscular injection of drugs to the hip. Before operation, there was difficulty in squatting and leg warping, and Obers sign was positive in the hip. According to the anatomical features of the hip, it was divided into 9 areas, and the boundary of the division was "well" zigzag grid. The boundary and important anatomical structures were projected on the body surface for reference. After operation, the patients were crouched down, the Oberus sign was ringing in the hip, the nerve and blood vessels were damaged, and the wound had hematoma or not. [results] the hip abductor muscle strength and its influence on life and work were comprehensively evaluated. [results] 96 cases were relieved in area 8, 68 cases in area 5, 52 cases in area 2 and 31 cases in area 4. All patients were followed up for more than one year. No Obers sign was found in all the patients, the hip bounce was negative, there was no nerve and vascular injury, and there was no postoperative wound hematoma in 1 case with weak abductor strength (grade 鈪，

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