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고관절 전치환술 후 하지 부동

Leg Length Discrepancy after Total Hip Arthroplasty

서근택|문규필|박원로
대한고관절학회 (The Korean Hip Society)|2010.03|Hip and Pelvis|제22권 제1호|pp. 20-26

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키워드

Leg length discrepancy고관절 전치환술Total hip arthroplasty하지 부동

초록

고관절 전치환술을 시행함에 있어서 femoral offset과 하지 길이 등 고관절의 생역학적인 기능을 회복시키는 것은 중요한 문제이다. 고관절 전치환술 후의 하지 부동은 요통, 좌골 신경통, 보행장애, 환자의 불만족, 탈구 등을 초래할 수 있는 주요한 요인이다. 심한 하지 길이 연장은 신경 손상을 초래할 수 있고, 고관절 전치환술 후 법적 소송의 흔한 원인이 되고 있다. 고관절 전치환술에서 하지 길이와 고관절의 안정성 사이에는 밀접한 관련이 있으며 정확한 하지 길이의 회복은 불가능할 수도 있다. 고관절의 전치환술을 시행함에 있어서 고관절의 안정성을 증가시키는 것이 더 중요하므로 안정적인 고관절의 재건을 위해서 하지 길이의 회복을 포기해야 할 수도 있다. 고관절 전치환술 후의 하지 부동을 완전히 예방하기는 어렵지만, 이학적 검사, 방사선학적 평가, 술전 templating, 술 중 확인 등의 여러 단계를 통하여 최소화시킬 수 있다.

Abstract

Restoration of the hip biomechanics, including the femoral offset and leg length, are the desired goals when performing total hip arthroplasty. A leg length discrepancy following total hip arthroplasty is a significant source of back pain and sciatica, gait disorders, general dissatisfaction and dislocation. Significant lengthening of the leg can be a risk factor for nerve injury and it is a relatively common cause of litigation. There is a fundamental interrelationship between leg length and stability when performing hip arthroplasty. There are a multitude of situations in which achieving both stability and perfectly equal leg lengths is simply not possible. Stability is the primary objective, and the surgeon may need to sacrifice leg length equality on the altar of stability. Although a leg length discrepancy cannot be eliminated after hip arthroplasty, it can be minimized through a series of steps, including a physical examination, radiographic evaluation, preoperative templating and intraoperative confirmation of the preoperative plan.

참고문헌 (40)

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관련 논문AI추천

인공관절 전치환술 후의 하지 부동김용식, 박범용, 임영욱대한고관절학회 · Hip and Pelvis2011 · 제23권 제4호하지길이 차이(Leg Length Discrepancy in Total Hip Arthroplasty)서근택대한고관절학회 · Hip and Pelvis2002 · 제14권 제4호고관절 치환술에서 술 중 방사선 촬영으로 하지부동의 최소화를 하는 유용한 방법김종원, 라종득, 박현수, 배성주, 양진필, 장영수, 최재혁대한고관절학회 · Hip and Pelvis2011 · 제23권 제4호인공관절 치환술 후의 하지부동임군일대한고관절학회 · Hip and Pelvis2004 · 제16권 제2호인공고관절 전치환술 후의 하지부동선두훈,남호진대한고관절학회 · Hip and Pelvis2006 · 제18권 제4호고위 고관절 탈구에서 대퇴골 단축을 시행하지 않은 고관절 전치환술박종석, 서유성, 어수익, 최상욱대한고관절학회 · Hip and Pelvis2009 · 제21권 제3호

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