There are many reasons for being unable to raise your legs, such as obesity, high muscle tone in the lower limbs caused by spinal cord disease, hip joint disease, gluteal muscle contracture, etc. Today we will mainly talk about the disease "gluteal muscle contracture". This is a disease that is gradually being forgotten, and the number of cases is decreasing year by year. Whenever you find a similar patient, it is enough to remind you of the sour pleasure of butt injections in your childhood.
Definition
Gluteal contracture is a fibrous degeneration and contracture of the gluteal muscles and their fascia caused by a variety of reasons, resulting in a unique gait and limited hip joint function. Clinical syndrome of signs.
Is gluteal muscle contracture equal to hip snapping?
Snapping hip is also called iliotibial band friction syndrome. Due to some reasons, the iliotibial band is thickened or tense, or the greater trochanter is too prominent, or there is bursitis, which can cause the two to rub against each other and produce snapping sounds when the hip joint moves. Another type of snapping hip is caused by congenital dislocation of the hip joint or loose joint capsule, causing snapping when the hip joint is hyperextended and externally rotated.
Cause
1
Injection factor: the most common cause of the disease, the frequency of affected muscles is gluteus maximus, tensor fascia lata, iliac External rotator muscles such as tibial band, gluteus minimus, gluteus medius, piriformis, etc.
2
Congenital factors The exact cause of primary gluteal muscle contracture is still unclear. Some experts believe that the disease is caused by congenital factors that cause muscle dysplasia or hypoplasia.
3
Hereditary factors It has been reported that some people with gluteal muscle contracture have a family history, and it is believed that it may be inherited in different ways under the influence of certain environmental factors.
4
Scar constitution Some scholars believe that gluteal muscle contracture is related to scar constitution.
5. Immune factors: low immune adhesion function of red blood cells
6. Age factors: children are susceptible to buttock intramuscular injection
7. Traumatic factors of the buttocks Trauma can cause congestion and edema in the gluteal muscles. In addition, the children's functional activities are poor after the injury, resulting in local scarring and hip joint dysfunction.
8. Surgical factors: mainly gluteal muscle contracture after congenital hip dislocation surgery.
Clinical manifestations
1. More common in children with a history of repeated intramuscular injections in the buttocks.
2. Abnormal gait, an external "eight" shape (external rotation of the foot) when walking or running, and inflexible running and jumping; when standing, the lower limbs cannot be completely close together and are slightly externally rotated; squatting When sitting, the knees cannot be brought together, like "frog pose"; when sitting, the knees should be separated and cannot be brought together. Do not cross your legs (cross your legs).
3. Part of the skin on the buttocks can be seen sunken into a groove, and hard cords can be touched along the direction of the gluteus maximus muscle fibers, which is obvious when the hip joint is adducted and internally rotated. There may be a popping sound when extending, flexing or rotating the hip joint. Ober's sign is positive.
4. Auxiliary examination tips: X-rays often show no obvious abnormalities, which can rule out other lesions of the hip joint. B-ultrasound and MRI examination showed that the hip muscles were atrophied to varying degrees, and some fiber cords were visible. Blood tests and electromyography were generally normal.
Clinical Grading
Grade I: When the hips and knees are flexed to 90° at the same time, the patient is strongly adducted, the knees can be brought together, it is difficult to cross the legs, and the Ober sign is weakly positive.
Second degree: Can take care of oneself, no "eight-step" when walking, but obvious "eight-step" when walking up and down stairs or running, and no "legs crossed". The upper outer part of the buttocks collapsed, there was an obvious "pointed buttock" deformity, and Ober's sign was positive.
Grade III: There is an obvious "eight-step" when walking, it is difficult to run, and it is difficult to put on pantyhose by oneself. When squatting, the hip joint is forced to abduct and externally rotate, resulting in "frog legs". The buttocks atrophied significantly, with severe "pointed buttocks" deformity, and the pelvis became narrow and elongated. Ober's sign is strongly positive.