Extension-abduction contracture of the hip joint as a consequence of gluteal fibrosis
Abstract. Introduction The disease that is manifested by primarily induced fibrotic changes in the gluteal muscles resulting in hip contractures and, in particular, in extension-abduction contracture of the hip joints has been known in the English literature as the “gluteal muscle contracture” and...
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| Formato: | article |
| Lenguaje: | EN RU |
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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2021
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| Acceso en línea: | https://doaj.org/article/caa40fe047774dcd83eccb707aedc325 |
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| Sumario: | Abstract. Introduction The disease that is manifested by primarily induced fibrotic changes in the gluteal muscles resulting in hip contractures and,
in particular, in extension-abduction contracture of the hip joints has been known in the English literature as the “gluteal muscle contracture” and
“gluteal fibrosis”. The world literature on the subject covers this pathology mostly in pediatric and adolescent patients, whereas this disease has not
been sufficiently discussed in the adult patients, even in foreign studies. Therefore, diagnostic methods, methods of examination and treatment of adult
patients have not been systematized and this nosology presents certain clinical and diagnostic difficulties for many domestic orthopedists. Materials
and methods We searched the PubMed and eLibrary systems for studies on the topic and used combinations of key words “gluteus muscle contracture”,
“gluteal fibrosis”, “gluteus maximus contracture”, “abduction contracture of the hip”, ”extension-abduction contracture of the hip”, “aplasia of gluteal
muscles” published from October 1974 to February 2020 and found a total of 106 results. The first publication coincides with the date of the initial
search period. The criteria for including studies in the analysis were a discussion of the issues of etiology and pathogenesis, epidemiology, diagnostic
criteria, clinical presentation, and approaches to the treatment of this pathology. We excluded articles related to the installation of gluteal implants and
other pathology of the gluteal region, so the number of articles decreased to 67, what means little investigation of this problem. Results Our analysis
showed that out of 67 articles, only 9 articles were related to issues of etiology and pathogenesis, five articles dealt with epidemiology, 15 dealt with
diagnostic criteria, treatment options were described in 12 articles, and the majority of publications focused on the results of surgical treatment of
clinical samples including 1-2 to 1280 cases. In the context of the 50-year-old depth of the literature search, the analysis indicates the fragmentation
of the material devoted to the gluteal muscle fibrosis published over this period of time, which requires the systematization and generalization of the
literature data accumulated to date. Conclusion Gluteal fibrosis is a rare independent disease, which is prevalent among certain ethnic groups. The
extension-abduction contracture of the hip joint develops due to gluteal fibrosis, the clinical picture of which has been very well documented and has
specific radiological signs. Surgical treatment methods vary, from open to endoscopic treatments and minimally invasive techniques. Since the main
group of patients described in the literature is children and adolescents and the surgical methods used are discussed for these age groups, treatment
methods and their efficacy for adult patients have been little reported. Therefore solution making is difficult for patients older than 18 years. It primarily
refers to providing specialized orthopedic care in places where ethnic groups with this pathology reside. |
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