Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Total Hip Arthroplasty without a Femoral Shortening Procedure for Treating a Highly Dislocated Hip

고위 고관절 탈구에서 대퇴골 단축을 시행하지 않은 고관절 전치환술

  • Park, Jong-Seok (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Sang-Wook (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University) ;
  • Awe, Soo-Ik (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University) ;
  • Suh, You-Sung (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University)
  • 박종석 (순천향대학교 의과대학 정형외과학교실) ;
  • 최상욱 (순천향대학교 의과대학 정형외과학교실) ;
  • 어수익 (순천향대학교 의과대학 정형외과학교실) ;
  • 서유성 (순천향대학교 의과대학 정형외과학교실)
  • Published : 2009.09.30

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Abstract

Purpose: This study evaluated the results of total hip arthroplasty (THA) without a femoral shortening procedure for the treatment of a highly dislocated hip. Materials and Methods: A total of 11 hips of 11 patients who underwent THA between April 1996 and February 2001 were clinically and radiologically evaluated. Among these 11 hips, 5 hips were sequelae of developmental dysplasia of the hip and 6 hips were sequelae of pyogenic or tuberculous infection. The mean follow-up period was 98 months (range: 88-121 months). Results: In all cases, the hip center was restored to the anatomic hip center. The mean Harris hip score increased from 56.2 preoperatively to 86.3 at the end of follow-up and the mean difference of the spino-malleolar distance decreased from 5.6 cm preoperatively to 1.4cm postoperatively. Non-union in the greater trochanter osteotomy site was encountered in two patients. Two cases of sciatic nerve palsy and one cases of heterotopic ossification occurred, but one case of sciatic nerve palsy recovered within 6 months. Conclusion: After enough soft tissue release, if reduction to the original hip center is difficult, then performing femoral osteotomy or shortening osteotomy should be considered during the THA for a highly dislocated hip.

목적: 고위 고관절 탈구에서 대퇴 단축 절골술 없이 시행한 인공 관절 전치환술의 결과를 분석하였다. 대상 및 방법: 1996년 4월부터 2001년 2월까지 시행한 고관절 전치환술 11명의 11예를 임상적 및 방사선학적으로 평가하였다. 5예는 발달성 고관절 탈구, 6예는 화농성 또는 결핵성 고관절염의 후유증이었다. 평균 추시 기간은 98개월(범위, 88~121개월)이었다. 결과: 11예 모두 해부학적 중심으로 고관절 중심부를 위치시켰다. 평균 Harris 고관절 점수는 수술 전 56.2점에서 최종 추시 상 86.3점으로 향상되었고, 수술 전 극내과 거리는 평균 5.6 cm에서 수술 후 1.4 cm로 교정되었다. 대전자부 절골술 부위의 불유합이 2예 있었고, 좌골 신경 마비 2예, 이소성 골화 1예가 발생하였으나 좌골 신경 마비 1예는 6개월 내 회복되었다. 결론: 고위 고관절 탈구에서 인공 고관절 전치환술을 시행할 때, 충분한 연부 조직 이완 후에도 관절 정복이 용이하지 않은 경우 대퇴 절골술 또는 단축 절골술을 고려해야 할 것으로 사료된다.

Keywords

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