本文選題：臀肌　切入點(diǎn)：攣縮帶　出處：《中國(guó)矯形外科雜志》2017年03期 　論文類型：期刊論文

【摘要】：[目的]探討髖部解剖體表投影分區(qū)對(duì)鏡下臀肌攣縮松解術(shù)的臨床價(jià)值。[方法]2014年12月~2015年7月間,對(duì)96例臀肌攣縮癥患者參考髖部解剖體表投影分區(qū)行關(guān)節(jié)鏡下攣縮帶松解手術(shù),男41例,女55例,平均年齡(24.9±4.4)歲(18~36歲)。患者均有反復(fù)臀部肌肉注射藥物史,術(shù)前查體均有下蹲及翹腿困難,髖部彈響,Ober’s征陽(yáng)性。髖部解剖體表投影分區(qū):依據(jù)髖部解剖學(xué)特征,將其劃分為9個(gè)區(qū),分區(qū)界線呈"井"字形網(wǎng)格,將界線及重要解剖結(jié)構(gòu)在體表投影標(biāo)記以供手術(shù)參考。術(shù)后對(duì)患者下蹲活動(dòng)、髖部彈響、Ober’s征、神經(jīng)血管有無(wú)損傷、傷口有無(wú)血腫、髖關(guān)節(jié)外展肌力及對(duì)生活工作影響情況進(jìn)行綜合評(píng)估。[結(jié)果]術(shù)中松解在第8區(qū)96例(100%),第5區(qū)68例(71%),第2區(qū)52例(54%),第4區(qū)31例(32%)。術(shù)后隨訪1年以上,患者均無(wú)下蹲及翹腿困難,Ober’s征、髖部彈響均為陰性,無(wú)神經(jīng)血管損傷,無(wú)術(shù)后傷口血腫,1例髖關(guān)節(jié)外展肌力弱(肌力Ⅳ級(jí))。臀肌攣縮功能評(píng)分術(shù)前為49.2(26~70)分,術(shù)后末次隨訪為91.2(81~100)分,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]手術(shù)安全區(qū)劃分有助于判定局部解剖結(jié)構(gòu),避免神經(jīng)血管肌肉等重要解剖結(jié)構(gòu)的損傷風(fēng)險(xiǎn),有助于描述記錄病變情況和教學(xué)。
[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 鹵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，

本文編號(hào)：1622457