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자기공명영상으로 선택된 환자에서의 대퇴전자간 회전 내전 절골술을 이용한 대퇴골두 무혈성 괴사환자의 치료
양진원 ( Jin Won Yang ),구경회 ( Kyung Hoi Koo ),송해룡 ( Hae Ryong Song ),정순택 ( Soon Taek Jeong ),박형빈 ( Hyung Bin Park ),이승환 ( Seung Hwan Lee ),정운하 ( Oun Hwa Chung ),조세현 ( Se Hyun Cho ) 대한고관절학회 1998 Hip and Pelvis Vol.10 No.2
We used MR(magnetic resonance) image to formulate new selection criteria for the identification of suitable patients with femoral head osteonecrosis for transtrochanteric rotational varizational osteotomy. The selection criteria included: [1] an early post-collapse osteonecrotic hip(loss of congruity or crescent sign) without narrowing of joint space or acetabular involvement; [2] an age of less than 55 years and a painful hip; [3] an angle of more than 120 of intact portion of the femoral head on midsagittal MR image. Seventeen patients met predefined selection criteria and were treated with the osteotomy. The angle of rotation was determined preoperatively in midsagittal MR image. The osteotomy included 20 of intentional varization. Postoperative scintigraphy showed adequate perfusion of the femoral head. They were followed for a period of 36 to 67 months(mean, 50 months). Hip score by Merle dAubigne et al improved from a mean of 13.4 preoperatively to a mean of 17.6 at the latest follow- up. Collapse of the feporal head was arrested in all hips and no case required a total hip arthroplasty. Use of MR images(kstead of plain radiograph) in the patient selection and in the determination of rotational angle may improve the success rate of the transtrochanteric rotational varizational osteotomy.