What is gluteus contracture?

  Gluteal muscle contracture, abbreviated as GMC, is mainly due to degeneration and contracture of the gluteal muscles and their fascial fibers, and in severe cases, atrophy of the gluteus maximus, gluteus medius, and gluteus minimus muscles to varying degrees, resulting in impaired internal retraction, internal rotation, and flexion of the hip joint, with patients often showing abnormal posture and gait when squatting and sitting, and other clinical syndromes that cause the characteristic gait and signs of restricted hip function.  The etiology and classification of the disease are not yet clear, but intramuscular injection of the hip is the main cause of the disease. Repeated injection, mechanical injury to the needle and chemical stimulation cause local hemorrhage, edema and myofibrillitis, and eventually form fibrosis and scar contracture of the gluteal muscle. The dose of the injected drug varies greatly in terms of the degree of tissue irritation and chemical damage, among which potassium penicillin diluted with benzyl alcohol can reduce the pain during intramuscular injection (benzyl alcohol has local anesthetic and antiseptic effects), but the irritation and chemical damage to the muscle tissue are more serious.  The age of onset of gluteus contracture is generally small, especially in early childhood. young children before 4 years old have poorly developed gluteus muscles, slender muscles, poor absorption function and resistance to stimulation, and the mechanical and chemical stimulation caused by repeated intramuscular injections can cause damage or bleeding in the local gluteus muscles and fascia; and hypotonic or highly concentrated drugs can lead to changes in the local fluid environment, or even toxic side effects of the drugs, causing muscle cells to degenerate and necrosis, gradually fibrosis, scarring and loss of elasticity.  Surgery is the main treatment for gluteal muscle contracture, and it is usually performed to release or remove the fibrous contracture tissue. However, due to the young age and poor self-discipline of patients with gluteus contracture, the surgery itself is more traumatic for the patients, and the poor habits in the past, even if the surgery is successful, if the postoperative rehabilitation training is not cooperated, it is difficult to achieve the ideal effect, and even leads to the recurrence of contracture. Therefore, it is especially important to conduct systematic early rehabilitation training after surgery.  In general, the rehabilitation training is to prevent or improve contracture, increase the strength of adductor and abductor muscles, gait and posture, coordination of gluteus maximus and lumbar back muscles, body balance, and pseudo-isometric length of both lower limbs. The specific training plan should be made by the rehabilitation doctor and therapist according to the patient’s actual condition.  Through postoperative rehabilitation training, the intraoperative joint correction can be maintained, normal muscle contraction movements can be maintained, disuse muscle contracture can be prevented, gluteus muscle adhesions can be avoided, and the recovery of gluteus muscle function can be promoted.