DOI QR코드

DOI QR Code

전방 도달법을 이용한 고관절 수술

Anterior Approaches in Hip Surgery

  • 김태영 (한림대학교 의과대학 정형외과학교실 골격노화연구소) ;
  • 차승환 (한림대학교 의과대학 정형외과학교실 골격노화연구소) ;
  • Otgonbayar Maidar (한림대학교 의과대학 정형외과학교실 골격노화연구소) ;
  • 이상수 (한림대학교 의과대학 정형외과학교실 골격노화연구소)
  • Kim, Tae-Young (Institute for Skeletal Aging, Department of Orthopaedic Surgery, College of Medicine, Hallym University) ;
  • Cha, Seung-Hwan (Institute for Skeletal Aging, Department of Orthopaedic Surgery, College of Medicine, Hallym University) ;
  • Maidar, Otgonbayar (Institute for Skeletal Aging, Department of Orthopaedic Surgery, College of Medicine, Hallym University) ;
  • Lee, Sang-Soo (Institute for Skeletal Aging, Department of Orthopaedic Surgery, College of Medicine, Hallym University)
  • 발행 : 2011.06.30

초록

고관절의 수술의 전방도달법은 크게 Smith-Petersen의 전방 도달법과 Watson-Jones의 전외방 도달법으로 구분되며 전방 도달법의 장점은 후방 도달법에 비하여 수술 후 탈구율이 낮은 점을 들 수 있으며, 인공 관절 수술 후 탈구율은 후방 접근 시 보다 2~3배 적게 발생하는 반면, 피부 절개가 커지고 시야 확보가 어려운 것이 단점이 있다. 그러나 이러한 전방도달법은 대퇴 골두의 혈류를 보존할 수 있는 장점을 가진 도달법이므로 고관절외과 분야에서 반드시 숙지하여야 할 내용이다.

The Smith-Petersen anterior approach and the Watson-Jones anterolateral approach are the two most renowned anterior approaches for hip surgery. The anterior approach offers several advantages, including a reduced dislocation risk as compared with that associated with the posterior approach. The post-operative dislocation rate after total hip arthroplasty is known to be 2~3 times lower than that of the posterior approach. However, a more extensive skin incision and poor anatomical visualization are some of the disadvantages of the anterior approach. Nevertheless, since this approach preserves the circulation to the femoral head, the ability to perform the anterior approach is imperative for hip surgeons.

키워드

참고문헌

  1. Moon DH. Anterior approach of the hip. J Korean Hip Soc. 2007;19:319-23.
  2. Hardinge K. The direct lateral approach to the hip. J Bone Joint Surg Br. 1982;64:17-9.
  3. Smith-Petersen MN. Approach to and exposure of the hip joint for mold arthroplasty. J Bone Joint Surg. 1949;31-A:40-6.
  4. Callaghan JJ, Rosenberg AG, Rubash HE. The adult hip. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. 685-94.
  5. Hoppenfeld S, deBoer P. Surgical exposure in orthopaedics. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2003. 365-453.
  6. Barton C, Kim PR. Complications of the direct anterior approach for total hip arthroplasty. Orthop Clin North Am. 2009;40:371-5. https://doi.org/10.1016/j.ocl.2009.04.004
  7. van Oldenrijk J, Hoogland PV, Tuijthof GJ, Corveleijn R, Noordenbos TW, Schafroth MU. Soft tissue damage after minimally invasive THA. Acta Orthop. 2010;81:696-702 https://doi.org/10.3109/17453674.2010.537804
  8. Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Ann Surg. 2000;232:281-6. https://doi.org/10.1097/00000658-200008000-00019
  9. Hueter C. Funfte abtheilung: die verletzung und krankheiten des huftgelenkes, neunundzwanzigstes capitel. In: Hueter C, ed. Leipzig: FCW Vogel; 1883. 129-200.
  10. Ince A, Kemper M, Waschke J, Hendrich C. Minimally invasive anterolateral approach to the hip: risk to the superior gluteal nerve. Acta Orthop. 2007;78:86-9. https://doi.org/10.1080/17453670610013466