Legg-Calve-Perthes 병에 있어서 대퇴골 내반 절골술의 장기 성적
The Long Term Results of Femoral Varus Osteotomy in Patients with Legg-Calve-Perthes Disease
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목적: Legg-Calve-Perthes 병의 치료를 위한 대퇴골 내반 절골술의 장기 성적을 보고하고자 하였다. 대상 및 방법: 대퇴골 내반 절골술을 시행하고 골성숙 시기까지 추시가 가능하였던 35명의 환자를 대상으로 하였다. 수술 당시 연령은 평균 8.6년(6.5~12.0년)이었다. 최종 결과의 분석은 Stulberg 분류를 사용하였으며 양하지 길이의 측정을 위하여 Teleoroentgenogram을 촬영하였다. 결과: Stulberg 분류에 의한 결과는 제 I군 4예 (11%), 제 II군 17예(49%), 제 III군 13예(37%), 제 IV군 1예(3%), 그리고 제 V군은 1예도 없었다. Stulberg 분류상 우수 21예(60%), 양호 13예 (37%), 그리고 불량 1예(3%)였다. 양하지 길이의 차이는 환지가 더 길어진 경우 3예(9%), 양하 지의 길이가 같은 경우 5예(14%)를 제외한 27예(77%)에서 지단축을 보였다. 그러나 21 mm 이 상의 지단축은 3예(9%)에서만 관찰되었다. 결론: Legg-Calve-Perthes 병에 있어서 수술적 유치를 목적으로 사용하는 대퇴골 절골술은 장 기 추시결과 우수(60%)와 양호(37%)율이 매우 높았으며 지단축의 후유증도 경미하였다.
Abstract
Purpose: The purpose of this study was to evaluate the long term results of performing femoral varus osteotomy (FVO) for the treatment of Legg-Calve-Perthes disease (LCPD). Materials and Methods: We selected 35 LCPD patients who received FVO and they were followed up to the time their skeletons’ matured. The inclusion criteria were patients in a fragmentation stage, the patients were in Catterall group Ⅲ or Ⅳ, and the patients underwent a teleoroentgenographic examination at the time of full skeletal maturity. Results: The radiological outcome at the time of skeletal maturity was assessed using Stulberg’s classification. The final results were 4 hips in class I, 17 hips in class II, 13 hips in class III, one hip in class IV and none in class V. The satisfactory results (good+fair hips) were 34 hips (97%). Significant shortening (>10 mm) was observed in 12 hips (34%). In 35 patients, 5 (14%) had same leg length (less than 2 mm difference), 27 (77%) had shortening of 2 mm or more, and 3 had lengthening of 2 mm or more in the operated limb. Of these 12 patients with significant shortening, only 3 patients (9%) showed shortening of 21 mm or more. Conclusion: FVO is a reliable method for managing LCPD in patients who are in Catterall group III or IV and who are in the fragmentation stage of disease.
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