Some basic knowledge about gluteal contracture
It is inevitable for people to get sick, and injections and medicine are the most common methods. When their children are sick, many parents think that giving their children medicine is not as good as giving them injections, which are quick and effective. Repeated injections and intramuscular injections of drugs can also cause illness. This is not alarmist.
25-year-old Xiao Wang encountered this situation. Xiao Wang received multiple buttock muscle injections due to multiple illnesses as a child. Later, he gradually discovered that his posture and gait were abnormal, especially when squatting. When sitting, the knee joints cannot be brought together and the legs must be separated; when sitting, the legs cannot be crossed; when lying on the supine position, the knee joints are separated, and when standing, the lower limbs are slightly externally rotated, and the feet cannot be completely brought together, forming an "outward splay" , walking staggeringly, especially when walking quickly or running, it appears to be jumping, resembling the weird "Chaplin's gait" on the stage.
By chance, someone told Xiao Wang that this was a disease. So Xiao Wang came to the Department of Orthopedics of Union Medical College Hospital for treatment. After careful examination, Professor Yang Shuhua diagnosed his disease as gluteal contracture, an adverse drug reaction caused by intramuscular injection of benzyl alcohol as a solvent. Then Xiao Wang was admitted to the hospital and underwent gluteal muscle contracture release surgery. On the second day after the operation, when Xiao Wang went out for activities, he found that the "Chaplin's gait" that had troubled him for many years had disappeared, and he could now cross his legs. Two weeks after the operation, Xiao Wang walked out of the hospital with satisfaction.
Professor Yang Shuhua, director of the Department of Orthopedics at Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, leader of the Hubei Provincial Expert Group on the Prevention and Treatment of Gluteal Contracture, and doctoral supervisor, said that many patients lack understanding of gluteal contracture. I didn't realize that my ugly walking posture was due to gluteal contracture, and I didn't seek medical treatment in time. If a child has received intramuscular injection of penicillin and cannot cross his legs smoothly, he should seek medical attention promptly. The only radical cure for this condition is surgical release of the contracture band in the gluteal muscles. The surgical technology is now very mature and the curative effect is very certain, but postoperative functional exercises are required to promote comprehensive recovery.
Next, let’s talk about some basic knowledge about gluteal contracture:
The causes of gluteal contracture
The most commonly used site for intramuscular injection is Buttock muscles, the suitable site for buttock injection is limited to the outer and upper quarter of the buttocks, because this part does not have important nerves and blood vessels, and from an anatomical structure, the deep muscles here are thicker and more suitable for injection. .
Gluteal contracture is a common condition primarily caused by repeated injections of drugs into the buttocks. According to a survey of 4,248 children in a domestic hospital, it was found that 200 children had injection gluteal contracture caused by repeated intramuscular injections, with an incidence rate of 4.7%.
The onset of gluteal contracture is related to physical damage caused by acupuncture, chemical stimulation caused by drugs, especially drug stimulation containing benzyl alcohol solutions, etc., leading to sterile muscle fiber necrosis and the development of muscle Fibrosis and scar contracture.
Benzyl alcohol is mostly used clinically for local anesthesia, disinfection and antisepsis. In the late 20th century, it was widely used as an injection solvent for penicillin potassium salt to reduce pain at the injection site. This method was widely used in hospitals across the country and is currently used in hospitals. Large urban hospitals are no longer in use, but many places in rural areas are still using them. The Ministry of Health issued a notice on February 16, 2005 to immediately stop using benzyl alcohol as a solvent for penicillin injections. Experts believe that gluteal muscle contracture is an adverse drug reaction and has no direct relationship with medical conditions (including disinfection, facilities, etc.).
Clinical manifestations of gluteal muscle contracture
Children initially find it difficult to squat, run, and jump, and walk with a limp. Further examination will reveal that the flexion, adduction, and internal rotation of the child's hip joint are limited; the lower limbs cannot be completely brought together and are slightly externally rotated; when squatting, the hips are abducted and externally rotated, and the knees cannot be brought together, forming a frog posture. Type position. The buttocks of most children do not look as plump as normal buttocks. The injected local muscles atrophy, the skin is sunken, sometimes orange peel-like, and cord-like capsules are palpable.
Key points of prevention and treatment of gluteal muscle contracture:
1. The key to preventing gluteal muscle contracture in children is that young parents should attach great importance to this disease. For sick children, try to reduce or avoid injecting highly toxic and irritating drugs into the buttock muscles, especially drugs diluted with benzyl alcohol.
2. The injection method and location must be correct, the dose must be reasonable, the injection speed must be slow, and try to avoid continuous injections at the same site. After injection, local hot compress and physical therapy should be carried out appropriately to facilitate the absorption of the medicinal solution and improve local blood circulation.
3. Once gluteal muscle contracture is discovered, early surgery should be performed to completely remove or release the contracted scar tissue. Most children with the disease can fully recover.
In short, injection gluteal contracture is a disease discovered in recent years that mainly affects children, and is one of the causes of claudication in children. If not treated in time, it may further damage the function of both hip joints, cause complications such as pelvic tilt and secondary scoliosis, and affect the normal development of the body. Experts call on grassroots medical staff and patients to pay full attention to it.