The Antomy And Clinical Research Of The Treatment Of Gluteal Muscle Constracture (GMC) With The Operation-the Percutaneous Cutting Of Contracture Fascia In The Relatively Safe Rejion

Objective To investigate the surface projection of the lowest branch of superior gluteus nerve and the operative relatively safe region, the appropriate body position and the indication of the operation of the percutaneous cutting of contracture fascia in the relatively safe rejion,to further investigate the effect of the operation of the percutaneous cutting of contracture fascia in the relatively safe rejion by the clinical application.Methods 1.Make lines from the most lateral protrusive point of the greater trochanter(L) to posterior superior iliac spine(B) and the top point of iliac crest(F) and the point of 6cm above the anterior superior iliac spine(K) and the point of 3cm above the anterior superior iliac spine (D)(LB,LF,LK,LD). Measure their distances and the distances between the lowest branch of superior gluteal nerve and the most lateral protrusive determined by 0.46×LB on LB is the intersection of the lowest branch of superior gluteal nerve and LB line, the point(G) determined by0.38×LF on LF is the intersection of the lowest branch of superior gluteal nerve and LF line, the point(E) determined by 0.40×LK on LK is the intersection of the lowest branch of superior gluteal nerve and LK line, the point(J) determined by0.45×LD on LD is the intersection of the lowest branch of superior gluteal nerve and LD line.The line between C.G.E.J is the surface projection of the lowest branch of the superior gluteal nerve.The similar scalloped area constituted by the arc line and the most lateral protrusive point of the greater trochanter is the relatively safe region.2. The gluteus contrature tissue of typical,mild and moderate cases can be moved to the relatively safe area through flexing and adducting the hip. The deep gluteal muscle contracture tissues of severe and special types can not be completely moved to the relatively safe zone.3.The operation time, postoperative pain, the time of exercise, post-operative hospital stay of the operation-the percutaneous cutting of contracture fascia in the relatively safe rejion have significant differences with the surgery through small cut (P<0.01), length of the incision has difference(p<0.05).The postoperative complications,and postoperative effect do not have the significant difference(p>0.05).Conclusions 1.The similar fan-shaped area constituted by the surface projection of the lowest branch of the superior and the most lateral protrusive point of the greater trochanter has no significant distribution of blood vessels and nerves.Through observing and measuring, the sciatic nerve can not reach this similar fan-shaped area, whether at the lower limbs straight bit or at different flexion position due to piriformis restrictions.This similar fan-shaped area is the relatively safe rejion of the surgery of gluteus muscle.2. Adducting and flexing the hip to 90°is the appropriate position of the operation of the percutaneous cutting of contracture fascia in the relatively safe rejion. The indication of the operation of the percutaneous cutting of contracture fascia in the relatively safe rejion are typical,light and midrange cases.3. The operation of the percutaneous cutting of contracture fascia in the relatively safe rejion is a safe, effective, economical and cosmetic way to treat the gluteal muscle contracture.This method is worthy of wide promotion.