Clinical classification of gluteal muscle contracture under arthroscopy / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of gluteal muscle contracture and minimum invasive surgery under the arthroscopy.</p><p><b>METHODS</b>Totally 358 patients with gluteus contracture were treated,which included 175 males and 183 females with an average age of (19.7 +/- 6.8) years old (ranged, 14 to 41). All patients have a history of repetitive intramuscular injection of penicillin with benzyl alcohol solvent. According to clinical characteristics and intraoperative situation, patients were classified into four groups:cable strip (118 cases), fanshaped (107 cases), mixed (87 cases), tensor fasciae latae contracture(46 cases). The curative effects were evaluated according to postoperative function evaluation standard of gluteus contracture.</p><p><b>RESULTS</b>All patients were followed up and 37 cases withdrew. The following up time ranged from 1.5 to 8 years with an average of 3.5 years. According to evaluation standard of gluteus contracture, 303 cases got excellent results, 13 cases good,and 5 cases fair at the final follow-up. No recurrence, infection and neurovascular injury occurred.</p><p><b>CONCLUSION</b>The classification of gluteal muscle contracture is beneficial for choose surgical strategy and improve curative effect. The advantage of plasma knife minimally invasive solution in treating gluteal muscle contracture with radiofrequency under arthroscopy is minimally invasive, safe, and benefit for early functional exercises.</p>

Release of gluteal muscle contracture by radiofrequency under arthroscopy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the clinical therapeutic effect of the release of gluteal muscle contracture by radiofrequency under arthroscopy.@*METHODS@#From January 2004 to April 2005, 86 patients with gluteal muscle contracture were treated by radiofrequency release under arthroscopy.The patients were followed-up for 6-18 months(mean=12.6 months).@*RESULTS@#Getting carriage, squatting down while keeping their knees contacting, crossing leg test, and impact on movement were served as evaluation criteria. Of the 86 patients, 79 had excellent results, 5 good, and the rest 2 were acceptable. There was no recurrence at the last follow-up, and all the patients were satisfied.@*CONCLUSION@#For gluteal muscle contracture, radiofrequency release under arthroscopy has minimally invasion, good results and quick recovery.

Psoas Abscess with Hip Contracture in a Patient with Crohn's Disease / 대한소화기학회지

A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.

Análise estática e radiológica da hiperlordose lombar como conseqüência do en-dehors na 1º posição dos pés no ballet clássico / Motionless and radiological analysis of lumbar spine hyperlordosis as a result of the turnout in the fi rst position of the feet in classical ballet

A 1ª posição dos pés – uma habilidade básica no ballet clássico – nada mais é do que a união da rotação externa dos quadris, associada à rotação externa das pernas e pés. Estes, associados à manutenção da postura correta, devem formar entre si um ângulo de 180º. Oobjetivo deste estudo foi verifi car se essa posição pode gerar uma hiperlordose lombar. Para tal, foram selecionadas 15 bailarinas com idades entre 15 e 28 anos, com um tempo médio de 13 anos de prática do ballet. Mensurou-se a rotação externa passiva dos quadris e pés. A partir das análises posturais e radiológicas estáticas, constatou-se que apenas duas das bailarinas, utilizando a postura correta,apresentavam hiperlordose na avaliação radiológica na 1ª posição. Dessa forma, concluiu-se que, provavelmente, o mau uso da postura,e não a prática do ballet, pode levar à hiperlordose lombar.

Th e 1st position of the feet – a basic skill in classical ballet – is essentially the external rotation of the hips in consonance with the external rotation of the legs and the feet. Th ese, in the correct posture, must form a 180-degree angle. Th e overall aim of this study is to verify if this position may lead to lumbar hyperlordosis. Forsuch purpose 15 female dancers were chosen, their ages ranging from 15 to 28, bearing an average of 13 years of ballet experience. They were interviewed and their passive external rotations of hips and feet were measured. Th en there were motionless postural and radiological analyses. Only two out of the 15 dancers showed hyperlordosis in the radiological evaluation while in the ideal position,pointing to the conclusion that hyperlordosis is not ballet-related;but to inappropriate use of correct ballet posture.

Experience of the treatment of the patients with polio consequences by Ilizarov's method in Pakistan

This study was conducted in the Midciti hospital, Karachi; Tahir Medical Center, Karachi; Majee Hospital, Hyderabad from Dec.2004 to Apr 2006 to show actuality of the problem of rehabilitation of Post Polio patients in Pakistan and efficiency and advantages of Ilizarov's Method in this matter. During the study period 100 patients were operated, all of them by Ilizarov's Method. Of these 62 were male and 38 females. Combined contracture of hip and knee joints with different degree of extremity shortening and foot deformity or instability were found in 26 cases; 62 patients had knee contracture with leg shortening and foot deformity or instability without hip contracture. Almost all of them were not able to walk without additional support. Some of them used orthopedic brace or crutches, others used to lock their knee by hand or by internal or external extremity rotation in combination with hand support. Two patients could move using wheel chair only and were crawling. Three-segment simultaneous surgical intervention was most common. In 90% of cases good and fair results where achieved and patients were satisfied. Deformities were corrected and required lengthening performed. After treatment most of the patients started to walk without any additional support; crawling and wheel chair patients are able to walk by using orthopaedic brace with sticks. It is concluded that Ilizarov's method is very affective and advanced for the treatment of Post-Polio patients and with well-skilled proper approach and application it is not so cumbersome as considered

Simultaneous correction of post-polio hip and knee joints contractue and foot deformity with limb lengthening by Ilizarov's method

We are presenting the case report of twelve years old girl, who had Post-Polio flexionabduction-external rotation contracture of hip joint, flexion contracture of knee joint, equines deformity of foot and limb shortening. She was treated by Ilizarov's Method in one stage and got excellent result

O teste de Thomas para cálculo da posição de flexão do quadril no plano sagital nas artrodeses / Thomas test to calculate flexion position of the hip in the arthrodesis sagittal plan

No Departamento de Ortopedia a Traumatologia da Santa Casa de São Paulo (SCMSP), Pavilhão "Fernandinho Simonsen", foram analisados 13 pacientes submetidos a duas formas de exame do teste de Thomas, além do exame radiográfico, com o objetivo de estabelecer a forma de medição mais precisa, compará-las com o exame radiográfico e determinar se existe correlação entre estas medidas. Os autores concluem que existe correlação entre os testes clínicos utilizados e a radiografia, porém há mais correlação no teste no qual se procura fletir o quadril ao máximo, em direção ao tórax, que proporciona maior retificação da lordose lombar.

No-unión en osteotomía de Chiari: descripción de tres casos clínicos / Non union in Chiari's osteotomy: description of 3 clinical cases

La osteotomía pélvica de Chiari es un procedimiento quirúrgico utilizado para el tratamiento de las displasias de cadera. Esta técnica no se encuentra libre de complicaciones, entre las cuales se encuentran lesiones nerviosas, infecciones y tromboembolismo, entre otras. Una complicación poco frecuente, pero que se encuentra descrita en la literatura, es la no-unión. En este trabajo se describen 3 casos de pseudoartrosis postostetomía de Chiari ocurridos en el Servicio de Ortopedia y Traumatología del Hospital Clínico de la Universidad de Chile entre los años 1987 y 2001

Retracción de miembros inferiores en un paciente con hipertiroidismo / Retraction of lower limbs in a patient with hyperthyroidism

We report a 47 years old woman with hyperthyroidism that had a severe tendinous retraction of hips and knees that subsided with propylthiouracil treatment. Electrodiagnosis showed myopathic alterations and muscle strength was moderately reduced. The authors did not find references of a similar condition in patients with hyperthyroidism

Miotomia seletiva de flexores do quadril em pacientes com paralisia cerebral. Analise retrospectiva a longo prazo / Selective myotomy of hip-flexors in patients with cerebral palsy: long term retrospective analysis

O autor analisou os resultados de miotomias seletivas de flexores do quadril em 42 pacientes com paralisia cerebral espástica num período de no mínimo três e no máximo 17 anos. Trinta e seis dos 42 pacientes que podiam caminhar tiveram maus resultados. Dificuldade para fletir as coxas, membros rodados para fora e maior amplitude de oscilaçäo lateral do tronco foram as características das dificuldades locomotoras pós-operatórias. Dentre as variáveis analisadas, somente deficiência do controle motor seletivo teve importância estatística (p<0,001) quanto aos resultados funcionais. Idade, capacidade pré-operatória de locomoçäo, padräo de comprometimento e imobilizaçäo pós-operatória tiveram influência irrelevante sobre os índices de recidiva ou hipercorreçäo.

Retraçäo do músculo quadríceps por injeçöes: análise comparativa de 12 pacientes operados / Retraction of the quadriceps muscle due to IM injection: comparative analysis of 12 patients

Os autores avaliam os resultados pós-operatórios de 12 pacientes com retraçäo do músculo quadríceps, devido a injeçöes intramusculares na face anterior da coxa (15 joelhos), submetidos a oito quadricepsplastias do tipo desinserçäo-deslizamento e a sete do tipo alongamento (Williams, Bennett). Foram analisados a força (torque máximo), a potência média e o trabalho total pela máquina do tipo Cybex 350, comparando-os aos critérios clínicos para graduaçäo de força. Concluem que os pacientes operados pela primeira técnica apresentaram melhor recuperaçäo funcional em relaçäo aos demais, que a avaliaçäo pela Cybex é mais precisa que os critérios clínicos e que a avaliaçäo isocinética é útil para fins comparativos nos casos unilaterais.

Contracture of the Hip Secondary to Fibrosis of the Gluteus Maximus Muscle / 대한정형외과학회잡지

Four patients were treated who had limited flexion of the hips and various degrees of contracture of the abduction and external rotator muscles because of fibrosis of the gluteus maximus muscle. Each patient had a typical restriction of motion such that an affected hip could not be flexed in the usual sagittal plane, but had to be flexed in abduction. Genetic, congenital and postnatal factors have been suggested as the cause of fibrosis of gluteus maximus muscle. Three of the 4 patients reported here are of congenital origin and another one is of postnatal factor repeated intramuscular injections. Excellent correction of the hip contracture was achieved in all patients by division of the fibrotic bands.

Flexion contraction of the hip

Diagnosis in 45 Cases, Flexion contraction of the Hip. Tuberculosis of the Hip. 15 Tuberculosis of the Spine with psoas spasm. 6 Acute retropertoneal a bscess psoas spasm. 2 Subacute retroperitoneal lymphadenitis with psoas spasm. 3 Mild Traumatic arthritis of hip. 4 Syphilitic Arthritis of hip. 2 Gonorrheal arthritis of hip. 1 Staphylococcus pyogenic arthritis of hip. 2 Non-pyogenic arthritis of hip. 2 Traumatic dislocation of hip, old. 1 Congenital dislocation of hips. 1 Bony metabolic disturbance (Endocrine ?). 1 Osteomyelitis of Femur, not intracapsular. 1 Acute deep abscess of thigh. 1 Gun shot wound of sacrum with chr.infection. 1 Metastatic Cancer with kyphosis. 1 Old Traumatic brain lesion. 1 Total 45 Tuberculosis