Hip & pelvis

  • 제23권4호
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  • Pages.262-267
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  • 2011
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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고관절 치환술에서 술 중 방사선 촬영으로 하지부동의 최소화를 하는 유용한 방법

Useful Method for Minimizing Leg Length Discrepancies in Hip Arthroplasty: Use of an Intraoperative X-ray

  • Kim, Jong-Won (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Jang, Young-Soo (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Park, Hyun-Soo (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Rha, Jong-Deuk (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Yang, Jin-Phil (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Choi, Jae-Hyuk (Department of Orthopedic Surgery, Hanil General Hospital) ;
  • Bae, Sung-Ju (Department of Orthopedic Surgery, Hanil General Hospital)
  • 발행 : 2011.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 고관절 치환술에서 하지 부동을 최소화 하는 방법에 대한 방법과 유용성에 대한 많은 의견이 있다. 저자는 술 전 가늠술(templating)과 더불어 술 중 방사선 촬영을 이용하여 하지 부동을 줄이는 방법의 유용성을 평가 하고자 한다. 대상 및 방법: 2008년 5월부터 2009년 2월까지 대퇴골 경부 및 전자간 골절 외상 환자의 치료로 고관절 치환술을 받은 환자 46예에 대하여 후향적 연구로 수술 전과 후의 골반부 방사선 사진을 검토 분석하였다. 골반부 전후 방사선 사진상 좌골 최하부를 연결한 수평선에서 대퇴골 소전자최원위부의 수직거리를 측정하여 하지 부동을 측정하였다. 모든 환자들은 술 전 가늠술을 시행한 후 술 중 골반 전후 방사선 사진을 통해 한차례 더 교정하였다. 결과: 술 후 하지 부동은 평균 0.3 mm(SD 3.1 mm)로 측정되었으며, 5.9 mm 연장에서 5.8 mm 단축까지의 범위 내로 측정 되었다. 결론: 술 전 가늠술과 더불어 술 중 골반부 전후 방사선 사진을 이용하여 인공 고관절 치환술 후 유의한 하지 길이의 단축 혹은 연장은 발견 되지 않았으며 하지 부동을 최소화할 것으로 사료된다.

Purpose: There are numerous opinions about the methods and usefulness of minimizing leg length discrepancies after hip arthroplasty. In this study, we tried to evaluate the usefulness of an intraoperative x-ray in addition to preoperative templating for minimizing leg length discrepancy. Materials and Methods: We reviewed pre- and post-operative pelvis AP x-rays of 46 patients who underwent hip arthroplasty due to a traumatic femoral neck fracture or intertrochanteric fracture between May 2008 and February 2009. A leg length discrepancy is the difference in vertical distance between a horizontal line drawn along the bottom of the ischial tuberosities and the most inferior points of the lesser trochanter. It was measured in a pelvis AP x-ray. In each case, pre-operative templating was performed and an intraoperative pelvis AP x-ray was taken again to assess the accuracy of preoperative planning. Implant positions were readjusted when necessary. Results: The mean post-operative leg-length discrepancy was 0.3 mm (SD, 3.1 mm). The range was from -5.8 mm to +5.9 mm. Conclusion: Combining preoperative templating and intraoperative x-rays is a useful method of minimizing leg length discrepancy during hip arthroplasty.

키워드

참고문헌

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