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Acetabular Remodeling and Role of Osteotomy After Closed Reduction of Developmental Dysplasia of the Hip : 발달성 고관절 이형성증의 도수 정복술 후 비구 재형성 및 절골술의 역할
DC Field | Value | Language |
---|---|---|
dc.contributor.advisor | 조태준 | - |
dc.contributor.author | 신창호 | - |
dc.date.accessioned | 2017-10-31T08:23:48Z | - |
dc.date.available | 2017-10-31T08:23:48Z | - |
dc.date.issued | 2017-08 | - |
dc.identifier.other | 000000145034 | - |
dc.identifier.uri | https://hdl.handle.net/10371/137980 | - |
dc.description | 학위논문 (석사)-- 서울대학교 대학원 의과대학 의학과, 2017. 8. 조태준. | - |
dc.description.abstract | Introduction: The purposes of this study were to evaluate acetabular remodeling after closed reduction of developmental dysplasia of the hip (DDH) and to delineate the role of osteotomy.
Materials and Methods: Eighty-four hips with DDH treated with closed reduction and followed until the patient was 8 years of age or older were included in this study. The mean age at closed reduction was 14.0 months (range, 3 to 30 months) and that at the latest follow-up visit was 12.7 years (range, 8.0 to 24.7 years). Osteotomy was performed in 26 hips (31%) during the follow-up period, at an average age of 2.8 years (range, 2.0 to 5.8 years). The acetabular index (AI) and center-edge angle (CEA) were measured, and osteonecrosis was graded. The treatment outcome was evaluated as satisfactory (Severin grade I or II) or unsatisfactory (III or IV). We retrospectively analyzed the associations among radiographic parameters, performance of osteotomy, grade of osteonecrosis, and Final outcome. Results: A satisfactory outcome was observed in 67 (80%) of the 84 hips. An osteotomy was not performed in 30 of 34 hips with an AI of <32° and a CEA of >14° at the age of 3 years, and 28 (93%) of these 30 hips showed a satisfactory outcome. Of the 33 hips with an AI of ≥32° and a CEA of ≤14° at the age of 3 years, the 20 that had undergone an osteotomy showed a higher proportion of satisfactory outcomes than the 13 hips that had not (p = 0.01). Three of the 4 hips that showed an unsatisfactory outcome following an osteotomy had an AI of ≥34° at 1 year post-osteotomy. Grade-II, III, or IV osteonecrosis, according to the Bucholz-Ogden classification, developed in 10 of the 84 hips, and these 10 hips had a higher proportion of unsatisfactory outcomes than did those that developed no or grade-I osteonecrosis (p = 0.004). Conclusion: Hips with DDH showing poor acetabular remodeling after closed reduction may benefit from osteotomy. The AI and CEA at the age of 3 years can serve as one of the guidelines for osteotomy. Continued surveillance for acetabular remodeling is required even after osteotomy. | - |
dc.description.tableofcontents | Introduction 1
Materials and Methods 3 Results 9 Discussion 19 References 25 Abstract in Korean 32 | - |
dc.format | application/pdf | - |
dc.format.extent | 1176453 bytes | - |
dc.format.medium | application/pdf | - |
dc.language.iso | en | - |
dc.publisher | 서울대학교 대학원 | - |
dc.subject | Developmental dysplasia of the hip (DDH) | - |
dc.subject | Closed reduction | - |
dc.subject | Osteotomy | - |
dc.subject | Acetabular remodeling | - |
dc.subject | Osteonecrosis | - |
dc.subject.ddc | 610 | - |
dc.title | Acetabular Remodeling and Role of Osteotomy After Closed Reduction of Developmental Dysplasia of the Hip | - |
dc.title.alternative | 발달성 고관절 이형성증의 도수 정복술 후 비구 재형성 및 절골술의 역할 | - |
dc.type | Thesis | - |
dc.description.degree | Master | - |
dc.contributor.affiliation | 의과대학 의학과 | - |
dc.date.awarded | 2017-08 | - |
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