medial hamstring transfer

Medial hamstring extramuscular surgery for the surgical treatment of hip deformities. Lumbar muscle retraction, the tendon and diaphragm muscle fibers are implanted into the anterior joint capsule of the hip near the base of the femoral neck. Applicable to: 1 hip flexion internal rotation, knee flexion (hamstring tendon); 2 hip flexion internal rotation, knee joint overextension (femoral quadriceps tendon); 3 hip joint flexion internal rotation, knee joint normal; 4 hip flexion deformity exceeds 15°. If the sick child walks with scissors gait or hip abduction limited to 15 °, then long muscle resection and obturator anterior branch resection; if the patient walks with knee extension, straight The muscle origin is released; if the sick child walks in a knee-knee gait, the tendon of the semitendinosus should be transposed to the medial malleolus of the femur, and the semimembranosus muscle is prolonged. When the triceps of the calf have contracted, the Achilles tendon is prolonged. Hip dislocation can be treated with adductor tendonectomy and iliopsoas retraction. After 5 years of age, femoral varus rotation osteotomy can be performed. For acetabular dysplasia, Pemberton hip osteotomy can be performed in children older than 10 years of age. After 10 years of age, femoral shortening rotation osteotomy and Chiari acetabular reconstruction are performed simultaneously with soft tissue surgery. Treating diseases: congenital hip varus Indication Medial hamstring extramuscular surgery is suitable for hip internal rotation deformity. Preoperative preparation Regular preoperative examination. Surgical procedure Sutherland Law: 1. Inflatable tourniquet on the proximal end of the thigh, and make an "S" shaped incision behind the knee. The proximal end of the incision starts from the lateral side of the armpit, the surface of the tendon of the biceps femoris, extending 7.5 cm distally, then extending inwardly along the transverse ridge across the armpit, and then extending the incision distally along the surface of the semitendinosus. 5 cm, free proximal flap. 2. Use a hemostat to pass under the semitendinosus and semimembranosus tendons and break them near their dead ends. Identify the gracilis tendon, free to the proximal end, and break off near its dead center. 3. Carefully free the phrenic nerve and the common peroneal nerve, expand the anatomical space in the superficial layer of the radial artery and vein, and deepen the nerve to the lateral muscle space. At the proximal end of the lateral femoral condyle, the lateral muscle spacing is severed at the attachment of the femoral periosteum. Carefully peel the lateral femoral muscle fibers from the front of the muscle compartment, pass the tendon through the incision on the septum, make a roundabout wrap, and then suture it to the proximal side of the tendon with a non-absorbent suture. Sometimes the semimembranosus muscle can be individually passed through the lateral muscle space, and then the semitendinosus muscle is sutured. Do not stretch too much when the tendon is fixed. The wound is sutured layer by layer.

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