Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

The Results after Surgically Managing Patients with Fibrous Dysplasia of the Proximal Femur

근위 대퇴골에 발생한 섬유성 골 이형성증의 수술적 치료방법에 따른 결과

  • Kim, Jeung-Il (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University) ;
  • Suh, Jeung-Tak (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University) ;
  • Suh, Kuen-Tak (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University) ;
  • Kim, Hui-Taek (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University) ;
  • Cheon, Sang-Jin (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University) ;
  • Moon, Nam-Hoon (Department of Orthopaedic Surgery, Colleage of Medicine, Pusan National University)
  • 김정일 (부산대학교 의학전문대학원 정형외과학교실) ;
  • 서정탁 (부산대학교 의학전문대학원 정형외과학교실) ;
  • 서근택 (부산대학교 의학전문대학원 정형외과학교실) ;
  • 김휘택 (부산대학교 의학전문대학원 정형외과학교실) ;
  • 천상진 (부산대학교 의학전문대학원 정형외과학교실) ;
  • 문남훈 (부산대학교 의학전문대학원 정형외과학교실)
  • Published : 2009.09.30

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Abstract

Purpose: Single or multiple fibrous dysplasia of the proximal femur can cause coxa vara, Shepherd's crook deformity and a leg length discrepancy for those patients who require surgical treatment. We wanted to evaluate the efficiency of surgical treating fibrous dysplasia of the proximal femur. Materials and Methods: Among the patients who underwent surgical treatment at our hospital during the period of June, 2001 to October, 2007, we selected 18 patients who underwent curettage and bone graft or valgus osteotomy and internal fixation due to proximal femur involvement. The clinical results were analyzed based on the patients' clinical records and radiologic findings. Results: The group of patients with a normal neck-shaft angle (Group 1) could achieve satisfactory results by undergoing curettage, bone graft and internal fixation. The other group of patients who progressed to Shepherd's crook deformity (Group 2) could have satisfactory results when they underwent valgus osteotomy and soft tissue release or both proximal femur shortening osteotomy and valgus osteotomy, but not with undergoing valgus osteotomy only. Conclusion: Varus deformity in patients with fibrous dysplasia may progress even though they undergo valgus osteotomy. It is important to consider the preoperative biomechanical condition of the proximal femur before performing surgery.

목적: 근위 대퇴골에 발생한 단발성 또는 다발성 섬유성 이형성증은 내반고, Shepherd's crook변형, 하지 부동을 야기하여 수술적 치료를 필요하게 된다. 저자들은 근위 대퇴골에 발생한 섬유성 이형성증에서 수술적 치료의 유용성을 평가하고자 한다. 대상 및 방법: 2001년 6월부터 2007년 10월까지 본원에서 수술적 치료를 시행한 섬유성 이형성증 환자 중 근위 대퇴골을 침범하여 소파술과 골이식술, 또는 외반 절골술과 내고정술을 시행한 18명을 대상으로 하였으며, 임상기록과 방사선학적 소견을 검토하여 임상적 결과를 분석하였다. 결과: 대퇴경간각이 정상인 군은(Group 1) 소파술과 골이식술, 내고정술을 이용하여 골유합을 얻을 수 있었다. Shepherd's crook 변형으로 진행한 군에서(Group 2) 외반 절골술과 연부 조직유리술 혹은 근위대퇴골 단축 절골술과 함께 외반 절골술을 시행한 경우는 만족스러운 결과를 얻었지만 외반 절골술만을 시행한 경우는 만족스러운 결과를 얻지 못하였다. 결론: Shepherd's crook 변형으로 진행된 섬유성 이형성증은 외반절골술을 시행하더라도 변형이 진행될 수 있다. 따라서 술 전 근위 대퇴골의 생역학적 조건을 고려하여 수술을 시행하는 것이 중요하다.

Keywords

References

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