Classification of gluteal muscle contracture in children and outcome of different treatments.
BACKGROUND
Gluteal muscle contracture (GMC) is a clinical syndrome due to multiple etiologies in which hip movements may be severely limited. The aim of this study was to propose a detailed classification of GMC and evaluate the statistical association between outcomes of different management and patient conditions.


METHODS
One hundred fifty-eight patients, who were treated between January 1995 and December 2004, were reviewed at a mean duration of follow-up of 4.8 years. Statistical analyses were performed using X2 and Fisher's exact tests.


RESULTS
Non-operative management (NOM), as a primary treatment, was effective in 19 of 49 patients (38.8%), while operative management was effective in all 129 patients, with an excellence rating of 83.7% (108/129). The outcome of NOM in level I patients was significantly higher than in level II and III patients (P < 0.05). The results of NOM and operative management in the child group were better than the adolescent group (P < 0.05). Complications in level III were more than in level II.


CONCLUSIONS
NOM was more effective in level I patients than in level II and III patients. Operative management was effective in patients at all levels, with no statistical differences between levels or types. We recommend NOM as primary treatment for level I patients and operative management for level II and III patients. Either NOM or operative management should be carried out as early as possible.
Department of Orthopaedic Surgery, The 2nd Affiliated Hospital of Medical College, Xi'an JiaoTong University, Xi'an, Shaanxi, 710004, PR China. Zhao_chenguang@live.cn
Chen-Guang
CG
Zhao
Xi-Jing
XJ
He
Bin
B
Lu
Hao-Peng
HP
Li
Dong
D
Wang
Zhen-Zhong
ZZ
Zhu
D000293:Adolescent; D002081:Buttocks; D002648:Child; D002675:Child, Preschool; D003972:Diathermy / Q000379:methods*; D005260:Female; D006616:Hip Contracture / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008405:Massage; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome