• 제목/요약/키워드: 비구 이형성증

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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;Park, Yong Geon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.359-365
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    • 2020
  • 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.

Ultrasonography in Developmental Dysplasia of Hip Part I: Technical Introduction (고관절 이형성증에서의 초음파의 사용 1부: 기술적 소개)

  • Lee, Soon Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.31-39
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    • 2008
  • After the introduction of ultrasound enabling a detailed view of both neonatal hip instability and morphology, two different streams have developed: one arguing that neonatal hip instability is the major pathology warranting treatment, the other including acetabular dysplasia as an important feature. Graf's method including the acetabular dysplasia led to higher treatment and follow-up rate than that based upon neonatal hip instability only. Recent report suggested that improved examination techniques and a better understanding of the findings have enabled a more tailored approach, and no differences in treatment rates exist due to different ultrasound techniques. I'd like to emphasize that enough experiences and the understanding enabling standardized examination and high repeatbility is more important than the choice of different techniques. Here the mothods and meanings of different techniques of ultrasound and its usefulness in the diagnosis and treatment of DDH is discussed.

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Study of Deformity by the Involvement of the Femoral Head of the Proximal Femur in Polyostotic Fibrous Dysplasia (다발성 섬유성 이형성증에서 근위 대퇴골두 침범 여부에 따른 변형 정도)

  • Na, Bo Ram;Jung, Sung Taek;Cho, Yong Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.519-527
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    • 2019
  • Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

A Case Report on a Patient with Osteoarthritis of the Hip Caused by Hip Dysplasia and Lumbar Spinal Stenosis, Treated by Postural Yinyang Correction of Temporomandibular Joint (비구이형성증에 의한 고관절염과 요추 척추관 협착증 환자의 턱관절자세 음양교정술을 이용한 치험 1례)

  • Lim, Jae-Eun;Kim, Kyoung-Min;Jang, Sun-Hee;Park, Eun-Jin;Lee, Young-Jun;Hong, Noo-Ri;Jang, Yeong-Suk;Yang, Su-Hyeon;Choi, Yun-Young;Oh, Da-Yoon;Lee, Soo-Jin;Kim, Cheol-Hong
    • Journal of TMJ Balancing Medicine
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    • v.9 no.1
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    • pp.12-17
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    • 2019
  • Objectives: The purpose of this study is to report the effect of Postural Yinyang Correction of Temporomandibular Joint (Functional Cerebrospinal Therapy, FCST) on a patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis. Methods: A patient with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis was treated at Dept. of Acupuncture & Moxibustion, ○○ University Korean Medicine Hospital from Nov 8th, 2019 to Dec 6th, 2019 and received a Korean-Western medical treatment mainly managed with FCST. This study was measured with VAS (Visual Analogue Scale), ODI (Oswestry Disability Index) and questionnaire. Results: After treatment, the patient's pain was controlled and gait ability was improved, also VAS, ODI and questionnaire score were improved. Conclusions: Korean-Western Medical Treatment mainly managed with FCST may be helpful in controling pain with Osteoarthritis of the hip caused by Hip dysplasia and Lumbar spinal stenosis, but the further researches are needed.

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