Deltoid contracture release

Tridular muscle contracture lysis is used for the treatment of deltoid muscle contracture. Skeletal muscle contracture refers to a disease in which skeletal muscle partial fibrosis causes corresponding joint dysfunction. Almost all muscle groups can contract, some of which are more clear, such as ischemic, traumatic or intramuscular injection, but some causes are still unclear, generally referred to as congenital. Lloyd-Roberts and Thomas reported that the sick child contracted quadriceps muscles several times after birth due to multiple intramuscular injections or infusions of the thigh. Domestic Ma Chengxuan first reported in 1978 that hip drug injection caused gluteus maximus contracture, and proposed the diagnosis name of injection gluteus maximal contracture. After more than 20 years of clinical observation, it has been recognized by most scholars. That is, repeated intramuscular injection in infants and young children, due to repeated mechanical damage of the injection needle and long-term chemical stimulation of the drug, causing local trauma of the skeletal muscle and chemical fibrosis, resulting in skeletal muscle fibrosis. However, not every infant who receives a drug has skeletal muscle fibrosis, so the exact pathogenesis remains unclear. Skeletal muscle contracture caused by a lack of clear history of drug injection is generally considered to be related to congenital genetic factors. Some scholars have reported that some of them are siblings, and some have two generations. In the skeletal muscle contracture muscle group, the most common affected are gluteus maximus, and a few are deltoid, quadriceps, triceps and rectus femoris. When the skeletal muscle contracture zone is formed, the corresponding joint function is limited. In terms of treatment, early passive activities in children receiving intramuscular injection can prevent their contracture to a certain extent. However, once the contracture band is formed, it must be relieved by surgery to relieve its clinical symptoms. Deltoid muscle contracture is mostly caused by intramuscular injection of deltoid muscle. The clinical manifestations may vary depending on the location of the deltoid muscle contracture, but the common clinical manifestation is that the shoulders are outreached, the upper limbs cannot be close to the trunk, the shoulder blades are prominent, the shoulders are sunken and rotated, and the skin of the deltoid muscle is visible. When the joint is adducted, the deformity is more obvious, and the part of the deltoid muscle can smash the constriction zone which is consistent with the direction of the muscle fiber. In addition to the obvious limitation of the internal fixation of the shoulder joint, other activities were not significantly restricted. In the case of severe contracture, the humeral head can protrude forward or subluxate. Once diagnosed, surgery should be taken. Treatment of diseases: congenital high shoulder scapula Indication The deltoid muscle contraction is applied to the deltoid muscle contracture affecting the shoulder joint recipient. Preoperative preparation 1. Examine the degree of deltoid muscle contraction and record the limitation of shoulder joint activity, especially the degree of shoulder joint restriction. 2. X-ray examination to understand the structure of the shoulder joint and whether there is a bone change. Surgical procedure Incision A longitudinal incision is made in the skin depression of the deltoid muscle, the length of which depends on the extent of the muscle contracture. 2. Deltoid muscle contracture release Cut the skin and subcutaneous tissue along the direction of the incision to reveal the deltoid contracture. Use a large bending forceps to pick up under the contracture band, cut it off, and cut the contracture tissue about 2cm to prevent postoperative adhesion. Passively move the shoulder joint on the operating table, especially the shoulder joint adduction activity check, whether the shoulder joint activity is free, whether there is still a contracture band in the deltoid muscle, if there is a contracture band, it must be completely loosened until the shoulder joint activity is not restricted. until. 3. Close the incision Wash the incision with saline, completely stop bleeding, and suture the skin and skin layer by layer. complication Head vein injury When the inner edge of the deltoid muscle is revealed, it is easy to damage the cephalic vein if it is not careful. 2. Radial nerve injury When the posterior marginal contracture of the deltoid muscle is released, the phrenic nerve is easily damaged.