Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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Pediatric Hip Disease (I): Diagnosis and Treatment of Developmental Dysplasia of the Hip

소아 고관절 질환(I): 발달성 고관절 이형성증의 진단 및 초기 치료

  • Kim, Hui Taek (Department of Orthopaedic Surgery, Pusan National University Hospital) ;
  • Park, Yong Geon (Department of Orthopaedic Surgery, Pusan National University Hospital)
  • Received : 2020.07.21
  • Accepted : 2020.09.19
  • Published : 2020.10.30
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Abstract

Developmental dysplasia of the hip broadly includes inadequate development of the hip joint involving the acetabulum or proximal femur, or both. Although ultrasonographic studies in neonates have greatly lowered the frequency of neglected or operatively treated cases, its sensitivity is less than desired. Hip dysplasia without subluxation is commonly diagnosed incidentally and strongly related to degenerative arthritis in females after the 4th decade. Hip dysplasia with subluxation shows symptoms through various periods, depending on its severity, especially for women with onset during pregnancy. A complete physical examination and early treatment for neonates are extremely important for obtaining satisfactory outcomes. To avoid underdiagnosis and to serve appropriate treatment on time, the authors recommend examining any suspicious hips in infants under two years of age. The study will discuss the diagnosis and primary treatment of developmental dysplasia of the hip.

소아 고관절 이형성증은 비구 또는 근위 대퇴골, 혹은 양쪽 모두를 포함하는 고관절의 부적절한 발달을 지칭하는 광범위한 개념이다. 초음파적 검사로 영아기의 고관절 탈구 진단이 간과되거나 수술적인 치료가 필요한 경우는 감소하고 있으나 모든 고관절 이형성증을 찾아내지는 못하고 있다. 아탈구가 없는 고관절 이형성증은 우연히 진단되며, 40대 이후 여자에서 퇴행성 관절염과 강한 연관성을 가진다. 아탈구를 동반한 고관절 이형성증은 아탈구의 정도에 따라 증상이 다양한 시기에 걸쳐 나타나며, 특히 여성에서 임신 중 발현되는 경우가 많다. 신생아에 대한 정확한 이학적 검사와 조기 치료는 이 질환의 양호한 결과를 위해 매우 중요하다. 진단의 간과를 막고 조기 치료의 기회를 제공하기 위해 저자는 고관절 이형성증이 의심스러운 2세 이하 영아 모두에게 고관절 검사를 추천한다. 본 연구에서는 고관절 이형성증의 진단 및 초기 치료에 대해 고찰해 보고자 한다.

Keywords

Acknowledgement

자료 수집과 의무기록 및 영상자료를 찾는 데 도움을 준 4년차 전공의 조윤재, 3년차 전공의 서한얼, 전세빈 선생에게 감사를 표합니다.

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