Minimally invasive scarless treatment for gluteus contracture

  Since the valderramar report in 1970, the incidence of gluteal muscle contracture (GMC) in China has been reported as 1~2.49%, and the highest reported incidence is 4.75%.  The present invention designs a simple, safe and reliable, minimally invasive stripping knife operation method under the guidance of C-arm machine and B-ultrasound for the treatment of gluteus contracture, which achieves less trauma, less pain, faster recovery, and good postoperative effect without leaving a scar.  The invention is realized in this way: it consists of four parts: minimally invasive stripping knife operation method, special surgical position, minimally invasive stripping and loosening part of the cut-off lengthening operation and special rehabilitation training exercises.  1, special equipment: (1) Ye’s minimally invasive stripping knife, (2) imported C-arm X-ray machine (auxiliary equipment) 2, minimally invasive stripping knife operation method: minimally invasive stripping knife (I have applied for a patent see Annex – minimally invasive stripping knife application form) in the C-arm machine and B-ultrasound guided by the work channel forward while separating and looking for the more tense contracture tissue. When using the knife tip, the sharp edge of the blade is first pierced parallel to the trailing edge of the forward-moving contracture tissue, and the side of the minimally invasive stripping knife is parallel to the deep side of the contracture tissue in front of the deep surface of the contracture tissue to place the knife tip and operating handle on the deep surface of the contracture tissue, separate the contracture tissue in layers with the back of the minimally invasive stripping knife, and then flip the sharp edge of the knife tip to cut the contracture tissue with a small pull-saw type.  3.Specialized surgical position: not announced yet.  4.Minimally invasive stripping and loosening of partial cut-off lengthening surgery: fix the position of the intersection of the horizontal line 1-4cm below the tip of the greater trochanter and the posterior edge of the greater trochanter, take only a 3mm long incision on one side of the hip with a minimally invasive stripping knife, and only strip and loosen a 3mm wide working channel in front of the greater trochanter, with the near point of the working channel being the flexion incision at the posterior edge of the greater trochanter and the far point being the intersection of the sagittal line at the near point and the anterior edge of the greater trochanter when the hip is extended. According to the preoperative diagnostic staging, the depth of the vertical greater trochanter is determined, and then the more tense contracture tissue is explored while separating forward.  The advantages of the invention are simple apparatus, easy operation, short operation time, less trauma, less pain, quick recovery, good effect, safe and reliable operation, and easy to master. After the surgery of patients with type A, B and C gluteus contracture in the orthopedic department of Shanghai Yangpu Hospital for the Aged and Anhui Bengbu Hospital, it is proved that the minimally invasive treatment can be used for walking on the ground, squatting with knees and stretched legs one day after the surgery, and can be cured and discharged from the hospital in four days. Since the minimally invasive scar is minimal and disappears after one month, there is no psychological stress caused by the obvious scar on the hip, which makes it easy to be accepted by patients with gluteus contracture for their benefit.  Because patients with gluteus contracture have a tendency to overgrow fibrous tissue, the scar left after open surgery causes lifelong regret for the patient. Our group has been conducting research on gluteus contracture for nearly 20 years, and has conducted applied anatomical studies, pathological studies, and controlled clinical follow-up studies on gluteus contracture, and has clarified the anatomical and pathological basis of stripping knife release lengthening for gluteus contracture; the clinical application of stripping knife release lengthening for gluteus contracture has proved that it is an operation with short operating time (1 to 2 minutes for one side of the scalpel) and minimal trauma (only one side of the gluteus). Small trauma (only a 3mm long incision is made on one side of the hip, and only a 3mm wide working channel is stripped and loosened in front of the greater trochanter), complete loosening (superficial and deep contracture tissues can be completely loosened), less pain (no pain during the whole operation), fast recovery (discharged from the hospital 4 days after the operation to resume normal life), good results (no scar left after the operation to walk and live like a normal person), safe and reliable and simple operation. It is a new procedure with the characteristics of safety, reliability and easy to master; the application of this technology can treat 98% of patients with gluteus contracture (type A, type B, type C), and the excellent rate of treated patients is currently 100%, and it has broken through the traditional age limit of gluteus contracture treatment (the traditional method of treatment is not ideal after the age of 17, while the “minimally invasive plastic treatment for contracture “(The highest age for treatment of contracture is over 53 years old). Since this procedure, i.e. minimally invasive scarless treatment for gluteus contracture (safe and reliable operation is simple and easy to master without expensive equipment input such as arthroscopy, it can be promoted nationwide and even worldwide, especially suitable for promotion in mountainous and rural areas where this disease is common.