Minimally invasive treatment of grade I and II gluteal muscle contracture using a self-made special cutter combined with a specialized compression hemostasis device

Background: To explore the method and curative effect of minimally invasive treatment of gluteal muscle contracture (GMC) with self-made special cutter combined with special compression hemostasis device.

Methods: The data of 88 patients with GMC treated in our hospital from May 2017 to January 2021 were analyzed retrospectively. They were divided into two groups according to different surgical instruments and hemostatic devices. The minimally invasive group consisted of 44 cases, including 18 males and 26 females aged between 7 and 25 years, with a disease duration ranging from 3 to 21 years. Among them, there were 27 cases of grade I and 17 cases of grade II who underwent treatment using a self-made special cutter for GMC combined with a self-made special compression hemostasis device. The traditional group also had 44 cases, including 17 males and 27 females aged between 6 and 23 years, with a disease duration ranging from 4 to 20 years. In this group, there were 25 cases of grade I and 19 cases of grade II who underwent open gluteal contracture fasciolysis combined with traditional abdominal band compression to stop bleeding. The incision length, operation time, intraoperative bleeding, and postoperative bleeding were compared between the two groups.

Results: There were no complications such as infection, hip instability and sciatic nerve injury in the two groups. The cross-leg test, knee squat, gait and movement returned to normal. Both Ober's sign and frog leg sign were negative. One patient in the traditional group developed a secondary hematoma after the incision, which was cured by incision and drainage again. The incision length (1.3 ± 0.2 cm) in the minimally invasive group was significantly shorter than that in the traditional group (6.4 ± 1.4 cm), and so was the operation time (46.3 ± 7.9 min vs. 62.2 ± 15.1 min). Meanwhile, the amount of intraoperative bleeding (33.7 ± 11.5 ml vs. 60.9 ± 25.0 ml) and postoperative bleeding (51.1 ± 19.4 vs. 112.9 ± 36.2 ml) in the minimally invasive group was significantly lower than that in the traditional group, respectively (P < 0.05).

Conclusion: The minimally invasive treatment of grade I and grade II GMC with a self-made special cutter combined with a special compression hemostatic device can achieve favorable clinical outcomes. Additionally, it causes less trauma, simplifies the operation, reduces intraoperative and postoperative bleeding, allows for early functional exercise, and promotes rapid functional recovery. Therefore, this treatment deserves clinical application.