발육성 고관절 탈구에서의 관절 조영술 -고관절 조영술과 수술소견과의 비교-

Arthrographic Evaluation in Developmental Dislocation of the Hip - Comparison Between Hip Arthrogram and Operative Findings -

이 연구에서 저자들은 다음과 같은 결론을 얻었다. 1. 고관절 조영술은 수술전에 미리 유용한 정보를 줌으로써 수술전 계획을 세우고 수술을 체계적으로할 수 있을것으로 사료된다. 따라서 고관절 조영술은 도수정복 혹은 수술적 정복전에 필수적으로 시행하여야 할 것으로 사료된다. 2. 고관절 조영술은 비구 관절순, 원형인대의 평가에 매우 유용하였으며, 횡비구인대에 대한 정보는 제한적이었다. 3. 고관절 조영술은 단순 방사선 촬영에 비하여 중앙연각의 평가에 훨씬 유용하고 실제 병리적 소견에 합당한 정보를 주었다.

One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram performs an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so that we can plan the reduction and treatment before operation. Eighteen preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved to be reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.