New Minimally Invasive Option for the Treatment of Gluteal Muscle Contracture

Abstract

Gluteal muscle contracture is a clinical syndrome that involves contracture and distortion of the gluteal muscles and fascia fibers due to multiple causes. Physical examination demonstrates a characteristic gait due to hip adduction and internal thigh rotation. This study introduces a new minimally invasive method for surgical release of gluteal muscle contracture. Patients with gluteal muscle contracture were assigned to 4 categories: type A, contracture occurred mainly in the iliotibial tract; type B, contracture occurred in the Iliotibial tract and gluteus maximus; type C1, movement of the contraction band was palpable and a snapping sound was audible during squatting; and type C2, movement of the contraction band was not palpable or almost absent and a snapping sound was audible during squatting. This classification method allowed prediction of the anatomic location of these pathological contractures and determination of the type of surgery required. Four critical points were used to define the operative field and served as points to mark a surgical incision smaller than 4 mm. The contracture was easily released in this carefully marked operative field without causing significant neurovascular damage. Over a period of 5 years, between March 2003 and June 2008, the authors treated 1059 patients with this method and achieved excellent outcomes. Most patients were fully active within 12 weeks, with the assistance of an early postoperative rehabilitation program. The most significant complication was a postoperative periarticular hematoma, which occurred in 3 patients within 10 days postoperatively and required surgical ligation of the bleeding vessel.

Gluteal muscle contracture: diagnosis and management options

“…Other features include out-toeing gait, flattened and cone-shaped buttock, apparent leg length discrepancy, pelvic obliquity, and compensatory lumbar scoliosis [8, 35]. The leg appears longer on the involved side as there is pelvic obliquity due to continuous traction by contracture bands.…”

“…While squatting, patients usually produce snapping sound as the fibrotic band glides over the greater trochanter, one may also palpate fibrotic band movement over greater trochanter [36]. Most of the patients have knee crepitus, most likely the consequence of chronic stress of rotational malalignment while they attempt to adjust the externally rotated knee [35]. Some patients may complain of anterior knee pain [37].…”

Arthroscopic release using F and C method versus conventional open release method in the treatment of gluteal muscle contracture: a comparative study

“…Subjective evaluations were performed using hip outcome scores (HOS), which assesses activities of daily living (HOS-ADL) and sports activities (HOS-Sports), and a visual analogue scale (VAS) for pain [17]. Objective clinical evaluation was performed using evaluation criteria set by Ye et al (2012) [14]. It includes 4 parameters.…”

“…GMC usually starts in early childhood, if left untreated it worsens gradually and persists throughout the life [14]. Because the disease mostly affects adolescents and adults, there is always an aesthetic concern.…”

Congenital contracture of the iliotibial tract: a case report

“…В зависимости от выраженности контракту-ры и на основании предложенных классифика-ций выполняют консервативные, эндоскопиче-ские и открытые хирургические вмешательства [2,4,8]. Авторы обращают внимание на то, что при сохраняющейся контрактуре могут форми-роваться вторичные деформации в виде перекоса таза, вальгусной деформации шейки бедренной кости и укорочения нижней конечности [9].…”