Operative management for children with pelvic obliquity caused by gluteal muscle contracture

Objective To explore the pathogenesis,operation and long-term results of pelvic obliquity secondary to gluteal muscle contracture in children.Methods Clinical data from 36 children with pelvic obliquity secondary to gluteal muscle contracture were retrospectively analyzed.All of them presented with inequality of lower limb,restriction of coxa adducta,false long leg and inclination of pelvis on anteroposterior radiograph(range from 5° to 28°,mean(15.5°)).The contractive gluteal muscles included gluteus maximus,and/or gluteus medius and/or gluteus minimus were completely released by operations.Results All patients suffered from the adductor contracture: 5 cases with gluteus medius contracture((13.89%)),21 cases with gluteus minimus contracture((58.33%)),and 10 cases with gluteus medius and gluteus minimus contracture((27.78%)).Thirty-two cases were followed up for an average of(3.5) years.Among them,27 cases obtained complete correction,5 cases including 3 cases which still showed light pelvic obliquity had mild restriction of adduction.No attenuation of abductor strength was noted in these children.Pelvic obliquity disappeared in 29 cases as demonstration by radiographical examination.Conclusions Abductor contracture of the hip,especially gluteus minimus,is primary factor that results in pelvic obliquity in children with gluteal muscle contracture.It is necessary to release the abductor contraction to get the satisfactory results in these patients.