Gluteal muscle contracture (GMC), presented with hip abduction and external rotation when crouching, is common in several ethnicities, particularly in Chinese. It remains unclear that the reasons why these children are weak and have no choice to accept repeated intramuscular injection. Here, we found some unique cases which may be useful to explain this question.We describe a series of special GMC patients, who are accompanied with congenital heart disease (CHD). These cases were first observed in preoperative examinations of a patient with atrial septal defect (ASD), which was proved by chest X-ray and cardiac ultrasound. From then on, we gradually identified additional 3 GMC patients with CHD. The original patient with ASD was sent to cardiosurgery department to repair atrial septal first and received arthroscopic surgery later. While the other 3 were cured postoperative of ventricular septal defect (VSD), tetralogy of fallot (TOF), patent ductus arteriosus (PDA), respectively, and had surgery directly.The study gives us 3 proposals: (1) as to CHD children, it is essential to decrease the use of intramuscular injection, (2) paying more attention to cardiac examination especially cardiac ultrasound in perioperative period, and (3) taking 3D-CT to reconstruct gluteal muscles for observing contracture bands clearly in preoperation. However, more larger series of patients are called for to confirm these findings.

Background:Tendon sheath giant cell tumor(GCT-TS) is an extremely rare tumor with highly nonspecific symptoms. It usually originates in the tendon sheath and periarticular soft tissue of the facet joint. Rarely involve the large joints that occur around the knees, ankles, elbows, and hip joints. The benign but aggressive disease progresses slowly. However, it can eventually lead to irreversible damage to the joint. Cace presensent: we briefly describe a misdiagnosed case of a giant cell tumor of the unilateral tendon sheath of the ankle joint. A 77-year-old man developed swelling in his ankle, which though mild, affected his walking gait and quality of life. At present, Conclusion:giant cell tumor of tendon sheath of ankle joint is very rare, and its clinical manifestations are not obvious, and it is often easy to be wrongly diagnosed. MRI is the best examination method to determine the scope of soft tissue destruction, and pathological examination is the most important means to diagnose giant cell tumor of tendon sheath at present.